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Alternative Therapies in Health and... Mar 2024This study aims to review recent developments in the diagnosis and treatment of Autism Spectrum Disorder (ASD )and provide insights for its clinical management. (Review)
Review
OBJECTIVE
This study aims to review recent developments in the diagnosis and treatment of Autism Spectrum Disorder (ASD )and provide insights for its clinical management.
METHODS
The literatures were researched fro the pubmed, Wanfang and CNKI. We searched for research on the etiology, pathogenesis, diagnosis (screening and evaluation), and treatment of Autism spectrum disorder. When selecting papers to be included, priority should be given to randomized clinical trials, systematic evaluations, meta-analyses, clinical practice guidelines, and articles related to general medical readers.
RESULTS
ASD is a widely present neurodevelopmental disorder characterized by social and communication difficulties, narrow interests, and repetitive behavior, accompanied by symptoms such as irritability, self-harm, attention deficit hyperactivity disorder (ADHD), and sleep problems. Irritability, self-harm, ADHD, and sleep problems are common accompanying symptoms that contribute to the challenges faced by individuals with ASD. At present, there is no fully effective treatment method for ASD, and key factors affecting the prognosis of ASD include early diagnosis time, early language communication level, intelligence level, disease severity, comorbidities, family participation, appropriate intervention, and social support. Therefore, early individualized long-term comprehensive training and drug therapy, hyperbaric oxygen therapy, and combined family participation can improve the prognosis of pediatric patients. Before selecting treatment plans for children, collecting as much information as possible about various treatment methods and choosing personalized treatment plans based on the child's developmental assessment level is necessary. In addition, the treatment of ASD is also influenced by factors such as family economic status, parental mentality, and social environment. During the training process, it is important to be family-centered, tolerant, and understand children's behavior.
CONCLUSION
It is significant to take effective treatment measures to improve the quality of life and prognosis of children with autism spectrum disorders.
Topics: Humans; Autism Spectrum Disorder; Child
PubMed: 37883758
DOI: No ID Found -
Journal of Neurodevelopmental Disorders Oct 2023Plasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of...
BACKGROUND
Plasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of particular importance in persons with DS given the high rates of autoimmune disease in this population and the known relationship between vitamin D and immune function. This study sought to investigate vitamin D status in a multi-center cohort of individuals with DS and compare them to individuals with autism spectrum disorder (ASD) and neurotypical (NT) controls.
METHODS
A retrospective, multi-center review was performed. The three sites were located at latitudes of 42.361145, 37.44466, and 34.05349. Patients were identified by the International Classification of Diseases (ICD)-9 or ICD-10 codes for DS, ASD, or well-child check visits for NT individuals. The first vitamin D 25-OH level recorded in the electronic medical record (EMR) was used in this study as it was felt to be the most reflective of a natural and non-supplemented state. Vitamin D 25-OH levels below 30 ng/mL were considered deficient.
RESULTS
In total, 1624 individuals with DS, 5208 with ASD, and 30,775 NT controls were identified. Individuals with DS had the lowest mean level of vitamin D 25-OH at 20.67 ng/mL, compared to those with ASD (23.48 ng/mL) and NT controls (29.20 ng/mL) (p < 0.001, 95% CI: -8.97 to -6.44). A total of 399 (24.6%) individuals with DS were considered vitamin D deficient compared to 1472 (28.3%) with ASD and 12,397 (40.3%) NT controls (p < 0.001, 95% CI: -5.43 to -2.36). Individuals with DS with higher body mass index (BMI) were found to be more likely to have lower levels of vitamin D (p < 0.001, 95% CI: -0.3849 to -0.1509). Additionally, having both DS and a neurologic diagnosis increased the likelihood of having lower vitamin D levels (p < 0.001, 95% CI: -5.02 to -1.28). Individuals with DS and autoimmune disease were much more likely to have lower vitamin D levels (p < 0.001, 95% CI: -6.22 to -1.55). Similarly, a history of autoimmunity in a first-degree relative also increased the likelihood of having lower levels of vitamin D in persons with DS (p = 0.01, 95% CI: -2.45 to -0.63).
CONCLUSIONS
Individuals with DS were noted to have hypovitaminosis D in comparison to individuals with ASD and NT controls. Associations between vitamin D deficiency and high BMI, personal autoimmunity, and familial autoimmunity were present in individuals with DS.
Topics: Humans; Autism Spectrum Disorder; Down Syndrome; Retrospective Studies; Vitamin D; Vitamin D Deficiency; Autoimmune Diseases
PubMed: 37880588
DOI: 10.1186/s11689-023-09503-y -
Journal of Integrative Neuroscience Jan 2024More than half of the patients with autism spectrum disorder (ASD) have gastrointestinal (GI) comorbidities, such as constipation, indigestion, abdominal pain, and... (Review)
Review
More than half of the patients with autism spectrum disorder (ASD) have gastrointestinal (GI) comorbidities, such as constipation, indigestion, abdominal pain, and diarrhea. Recent studies suggest prescribing probiotics and prebiotics in ASD could relieve GI disturbances and behavioral issues. This narrative review generalizes the research progress on probiotic and prebiotic therapies for ASD over the past 5 years and further discusses the underlying mechanisms of interaction between probiotics and prebiotics with ASD. Preliminary evidence has demonstrated the beneficial effects of probiotics and prebiotics on GI problems, autism-related behavioral disorders, and gut microbiome composition; the mechanism of probiotics and prebiotics in the treatment of ASD is mediated through inflammatory signaling pathways, metabolic pathways, neuronal signaling pathways, and the involvement of the vagus nerve. However, the results are inconclusive and mainly generated by animal experiments. Overall, the present review recommends further standardization of clinical studies to draw more robust evidence for prescribing probiotics and prebiotics in ASD.
Topics: Animals; Humans; Prebiotics; Autism Spectrum Disorder; Probiotics; Gastrointestinal Diseases; Gastrointestinal Microbiome
PubMed: 38287844
DOI: 10.31083/j.jin2301020 -
Endocrine Regulations Jan 2024Oxytocin plays an important role in brain development and is associated with various neurotransmitter systems in the brain. Abnormalities in the production, secretion,... (Review)
Review
Oxytocin plays an important role in brain development and is associated with various neurotransmitter systems in the brain. Abnormalities in the production, secretion, and distribution of oxytocin in the brain, at least during some stages of the development, are critical for the pathogenesis of neuropsychiatric diseases, particularly in the autism spectrum disorder. The etiology of autism includes changes in local sensory and dopaminergic areas of the brain, which are also supplied by the hypothalamic sources of oxytocin. It is very important to understand their mutual relationship. In this review, the relationship of oxytocin with several components of the dopaminergic system, gamma-aminobutyric acid (GABA) inhibitory neurotransmission and their alterations in the autism spectrum disorder is discussed. Special attention has been paid to the results describing a reduced expression of inhibitory GABAergic markers in the brain in the context of dopaminergic areas in various models of autism. It is presumed that the altered GABAergic neurotransmission, due to the absence or dysfunction of oxytocin at certain developmental stages, disinhibits the dopaminergic signaling and contributes to the autism symptoms.
Topics: Oxytocin; Humans; Dopamine; gamma-Aminobutyric Acid; Autistic Disorder; Brain; Animals; Synaptic Transmission; Autism Spectrum Disorder
PubMed: 38656256
DOI: 10.2478/enr-2024-0012 -
Biological Psychiatry Jul 2023The use of the term "social attention" (SA) in the cognitive neuroscience and developmental psychopathology literature has increased exponentially in recent years, in... (Review)
Review
The use of the term "social attention" (SA) in the cognitive neuroscience and developmental psychopathology literature has increased exponentially in recent years, in part motivated by the aim to understand the early development of autism spectrum disorder (ASD). Unfortunately, theoretical discussions around the term have lagged behind its various uses. Here, we evaluate SA through a review of key candidate SA phenotypes emerging early in life, from newborn gaze cueing and preference for face-like configurations to later emerging skills such as joint attention. We argue that most of the considered SA phenotypes are unlikely to represent unique socioattentional processes and instead have to be understood in the broader context of bottom-up and emerging top-down (domain-general) attention. Some types of SA behaviors (e.g., initiation of joint attention) are linked to the early development of ASD, but this may reflect differences in social motivation rather than attention per se. Several SA candidates are not linked to ASD early in life, including the ones that may represent uniquely socioattentional processes (e.g., orienting to faces, predicting others' manual action goals). Although SA may be a useful superordinate category under which one can organize certain research questions, the widespread use of the term without proper definition is problematic. Characterizing gaze patterns and visual attention in social contexts in infants at elevated likelihood of ASD may facilitate early detection, but conceptual clarity regarding the underlying processes at play is needed to sharpen research questions and identify potential targets for early intervention.
Topics: Humans; Autism Spectrum Disorder; Social Behavior; Social Environment; Phenotype; Cues
PubMed: 36639295
DOI: 10.1016/j.biopsych.2022.09.035 -
Journal of Healthcare Engineering 2023Autism spectrum disorder is a severe, life-prolonged neurodevelopmental disease typified by disabilities that are chronic or limited in the development of...
Autism spectrum disorder is a severe, life-prolonged neurodevelopmental disease typified by disabilities that are chronic or limited in the development of socio-communication skills, thinking abilities, activities, and behavior. In children aged two to three years, the symptoms of autism are more evident and easier to recognize. The major part of the existing literature on autism spectrum disorder is covered by a prediction system based on traditional machine learning algorithms such as support vector machine, random forest, multiple layer perceptron, naive Bayes, convolution neural network, and deep neural network. The proposed models are validated by using performance measurement parameters such as accuracy, precision, and recall. In this research, autism spectrum disorder prediction has been investigated and compared using common parameters such as application type, simulation method, comparison methodology, and input data. The key purpose of this study is to give a centralized framework to use for researchers working on autism spectrum disorder prediction. The best results were obtained by using the random forest algorithm as it performs better than other traditional machine learning algorithms. The achieved accuracy is 89.23%. The workflow representations of the investigated frameworks assist readers in comprehending the fundamental workings and architectures of these frameworks.
Topics: Child; Humans; Autism Spectrum Disorder; Bayes Theorem; Machine Learning; Neural Networks, Computer; Algorithms; Support Vector Machine
PubMed: 37469788
DOI: 10.1155/2023/4853800 -
American Journal of Obstetrics &... Aug 2023Oxytocin is a neuropeptide hormone that plays a key role in social behavior, stress regulation, and mental health. Synthetic oxytocin administration is a common...
BACKGROUND
Oxytocin is a neuropeptide hormone that plays a key role in social behavior, stress regulation, and mental health. Synthetic oxytocin administration is a common obstetrical practice, and importantly, previous research has suggested that intrapartum exposure may increase the risk of neurodevelopmental disorders, such as autism spectrum disorder.
OBJECTIVE
This study aimed to examine the association between synthetic oxytocin exposure during labor and autism spectrum disorder diagnosis in the child.
STUDY DESIGN
This population-based retrospective cohort study compared 2 cohorts of children: (1) all children born in British Columbia, Canada between April 1, 2000 and December 31, 2014 (n=414,336 births), and (2) all children delivered at Soroka University Medical Center in Be'er-Sheva, Israel between January 1, 2011 and December 31, 2019 (n=82,892 births). Nine different exposure groups were examined. Cox proportional hazards models were used to estimate crude and adjusted hazard ratios of autism spectrum disorder in both cohorts on the basis of induction and/or augmentation exposure status. To further control for confounding by indication, we conducted sensitivity analyses among a cohort of healthy, uncomplicated deliveries and among a group that was induced only for postdates. In addition, we stratified our analyses by infant sex to assess for potential sex differences.
RESULTS
In the British Columbia cohort, 170,013 of 414,336 deliveries (41.0%) were not induced or augmented, 107,543 (26.0%) were exposed to oxytocin, and 136,780 (33.0%) were induced or augmented but not exposed to oxytocin. In the Israel cohort, 51,790 of 82,892 deliveries (62.5%) were not induced or augmented, 28,852 (34.8%) were exposed to oxytocin, and 2250 (2.7%) were induced or augmented but not exposed to oxytocin. On adjusting for covariates in the main analysis, significant associations were observed in the Israel cohort, including adjusted hazard ratios of 1.51 (95% confidence interval, 1.20-1.90) for oxytocin-augmented births and 2.18 (95% confidence interval, 1.32-3.57) for those induced by means other than oxytocin and not augmented. However, oxytocin induction was not significantly associated with autism spectrum disorder in the Israel cohort. In the Canadian cohort, there were no statistically significant adjusted hazard ratios. Further, no significant sex differences were observed in the fully adjusted models.
CONCLUSION
This study supports that induction of labor through oxytocin administration does not increase the risk of autism spectrum disorder in the child. Our international comparison of 2 countries with differences in clinical practice regarding oxytocin administration for induction and/or augmentation suggests that previous studies reporting a significant association were likely confounded by the underlying indication for the induction.
Topics: Pregnancy; Child; Infant; Humans; Male; Female; Oxytocin; Autism Spectrum Disorder; Retrospective Studies; Labor, Induced; Canada
PubMed: 37156463
DOI: 10.1016/j.ajogmf.2023.101010 -
Neuroscience and Biobehavioral Reviews Jul 2024The relationship between autism spectrum disorder (ASD) and sexual offending (SO) is an overlooked issue, both in clinical practice and in research. Based on a... (Review)
Review
The relationship between autism spectrum disorder (ASD) and sexual offending (SO) is an overlooked issue, both in clinical practice and in research. Based on a pre-specified protocol (PROSPERO: CRD42024501598), we systematically searched Pubmed and Scopus, between January 1st, 1994 and January 12th, 2024, for articles related to SO in ASD. Study quality was assessed with study design-specific tools (Study Quality Assessment Tools, NHLBI, NIH). We found 19 relevant publications (five cross-sectional studies, two case-control studies, and 12 case reports). Seven of the studies were deemed of "good" quality, the rest as "fair". Included studies addressed three key aspects: 1) psychopathological characteristics of individuals with ASD that increase the risk of committing SO; 2) intervention strategies for individuals with ASD and SO; 3) involvement of individuals with ASD and SO in the justice system. Overall, while there is an increasing interest in this topic, more rigorous study designs, including randomised controlled trials, are needed to inform clinical practice and healthcare and social policies.
Topics: Humans; Autism Spectrum Disorder; Sex Offenses; Criminals
PubMed: 38685290
DOI: 10.1016/j.neubiorev.2024.105687 -
Journal of Autism and Developmental... Sep 2023This study evaluated the association of autistic traits (RAADS-14) with academic and social outcomes among college students using data from an online survey...
This study evaluated the association of autistic traits (RAADS-14) with academic and social outcomes among college students using data from an online survey (Nā=ā2,736). In the academic domain, the total trait score and all subscale scores (mentalizing deficits, social anxiety, sensory reactivity) were associated with course failure and academic difficulties independent of an autism diagnosis; the total score and mentalizing deficits also predicted lower grade point average (GPA). In the social domain, the total trait score and subscale scores were associated with lower odds of having a confidant, lower friendship quality, and higher odds of social exclusion. Subgroup analyses revealed that autistic traits had more consistently negative associations with social outcomes for students without an autism diagnosis than for students with a diagnosis. Associations were also more often significant for women than men. These results support the development of programs and services for students with autistic traits regardless of diagnostic status.
Topics: Autism Spectrum Disorder; Universities; Adaptation, Psychological; Humans; Male; Female; Sex Characteristics; Sex Factors; Indiana; Adolescent; Young Adult; Surveys and Questionnaires; Mentalization; Anxiety; Social Isolation; Friends; Missed Diagnosis
PubMed: 35796912
DOI: 10.1007/s10803-022-05632-w -
Diagnostic yield and clinical impact of chromosomal microarray analysis in autism spectrum disorder.Molecular Genetics & Genomic Medicine Aug 2023Autism spectrum disorder (ASD) is characterized by high heritability estimates and recurrence rates; its genetic underpinnings are very heterogeneous and include...
BACKGROUND
Autism spectrum disorder (ASD) is characterized by high heritability estimates and recurrence rates; its genetic underpinnings are very heterogeneous and include variable combinations of common and rare variants. Array-comparative genomic hybridization (aCGH) offers significant sensitivity for the identification of copy number variants (CNVs), which can act as susceptibility or causal factors for ASD.
METHODS
The aim of this study was to evaluate both diagnostic yield and clinical impact of aCGH in 329 ASD patients of Italian descent.
RESULTS
Pathogenic/likely pathogenic CNVs were identified in 50/329 (15.2%) patients, whereas 89/329 (27.1%) carry variants of uncertain significance. The 10 most enriched gene sets identified by Gene Ontology Enrichment Analysis are primarily involved in neuronal function and synaptic connectivity. In 13/50 (26.0%) patients with pathogenic/likely pathogenic CNVs, the outcome of array-CGH led to the request of 25 additional medical exams which would not have otherwise been prescribed, mainly including brain MRI, EEG, EKG, and/or cardiac ultrasound. A positive outcome was obtained in 12/25 (48.0%) of these additional tests.
CONCLUSIONS
This study confirms the satisfactory diagnostic yield of aCGH, underscoring its potential for better, more in-depth care of children with autism when genetic results are analyzed also with a focus on patient management.
Topics: Child; Humans; Autism Spectrum Disorder; Comparative Genomic Hybridization; Microarray Analysis; Autistic Disorder; DNA Copy Number Variations
PubMed: 37186221
DOI: 10.1002/mgg3.2182