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Pharmacotherapy May 2017Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the... (Meta-Analysis)
Meta-Analysis Review
Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians' decision making for a majority of the identified sleep problems in the ASD population.
Topics: Autism Spectrum Disorder; Behavior Therapy; Child; Early Medical Intervention; Humans; Melatonin; Sleep Wake Disorders
PubMed: 28258648
DOI: 10.1002/phar.1920 -
Mitochondrion May 2019Mitochondria are small cytosolic organelles and the main source of energy production for the cells, especially in the brain. This organelle has its own genome, the...
Mitochondria are small cytosolic organelles and the main source of energy production for the cells, especially in the brain. This organelle has its own genome, the mitochondrial DNA (mtDNA), and genetic variants in this molecule can alter the normal energy metabolism in the brain, contributing to the development of a wide assortment of Neurological Disorders (ND), including neurodevelopmental syndromes, neurodegenerative diseases and neuropsychiatric disorders. These ND are comprised by a heterogeneous group of syndromes and diseases that encompass different cognitive phenotypes and behavioral disorders, such as autism, Asperger's syndrome, pervasive developmental disorder, attention deficit hyperactivity disorder, Huntington disease, Leigh Syndrome and bipolar disorder. In this work we carried out a Systematic Literature Review (SLR) to identify and describe the mitochondrial genetic variants associated with the occurrence of ND. Most of genetic variants found in mtDNA were associated with Single Nucleotide Polimorphisms (SNPs), ~79%, with ~15% corresponding to deletions, ~3% to Copy Number Variations (CNVs), ~2% to insertions and another 1% included mtDNA replication problems and genetic rearrangements. We also found that most of the variants were associated with coding regions of mitochondrial proteins but were also found in regulatory transcripts (tRNA and rRNA) and in the D-Loop replication region of the mtDNA. After analysis of mtDNA deletions and CNV, none of them occur in the D-Loop region. This SLR shows that all transcribed mtDNA molecules have mutations correlated with ND. Finally, we describe that all mtDNA variants found were associated with deterioration of cognitive (dementia) and intellectual functions, learning disabilities, developmental delays, and personality and behavior problems.
Topics: DNA, Mitochondrial; Genetic Predisposition to Disease; Genetic Variation; Humans; Nervous System Diseases
PubMed: 30218715
DOI: 10.1016/j.mito.2018.09.005 -
Clinical Psychology Review Nov 2016The aims of this study were to undertake a meta-analytic and systematic appraisal of the literature investigating the effectiveness of cognitive behavioural therapy... (Meta-Analysis)
Meta-Analysis Review
The aims of this study were to undertake a meta-analytic and systematic appraisal of the literature investigating the effectiveness of cognitive behavioural therapy (CBT) when used with individuals who have autistic spectrum disorders (ASDs) for either a) affective disorders, or b) the symptoms of ASDs. Following a systematic search, 48 studies were included. CBT, used for affective disorders, was associated with a non-significant small to medium effect size, g=0.24, for self-report measures, a significant medium effect size, g=0.66, for informant-report measures, and a significant medium effect size, g=0.73, for clinician-report measures. CBT, used as a treatment for symptoms of ASDs, was associated with a small to medium non-significant effect size, g=0.25, for self-report measures, a significant small to medium effect size, g=0.48, for informant-report measures, a significant medium effect size, g=0.65, for clinician-report measures, and a significant small to medium effect size, g=0.35, for task-based measures. Sensitivity analyses reduced effect size magnitude, with the exception of that based on informant-report measures for the symptoms of ASDs, which increased, g=0.52. Definitive trials are needed to demonstrate that CBT is an empirically validated treatment for use with people who have ASDs.
Topics: Autism Spectrum Disorder; Cognitive Behavioral Therapy; Humans; Outcome Assessment, Health Care
PubMed: 27592496
DOI: 10.1016/j.cpr.2016.08.001 -
Developmental Neurorehabilitation Apr 2018To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism... (Review)
Review
PURPOSE
To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism spectrum disorder (ASD).
METHODS
We present a systematic review and narrative synthesis of the determinants of external validity in RCTs on ER training. Generalizability of the findings across situations, populations, settings, treatment delivery, and intervention formats was considered.
RESULTS
We identified 13 eligible studies. Participants were predominantly boys with ASD in the normative IQ range (IQ > 70), with an age span from 4 to 18 years across studies. Interventions and outcome measures were highly variable. Several studies indicated that training may improve ER, but it is still largely unknown to what extent training effects are translated to daily social life.
CONCLUSION
The generalizability of findings from currently available RCTs remains unclear. This underscores the importance of involving children with ASD and their caregivers in informed treatment decisions.
Topics: Adolescent; Autism Spectrum Disorder; Child; Emotions; Female; Humans; Male; Randomized Controlled Trials as Topic; Social Skills
PubMed: 28394669
DOI: 10.1080/17518423.2017.1305004 -
The International Journal of Eating... May 2007The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center systematically reviewed evidence on factors associated with outcomes... (Review)
Review
OBJECTIVE
The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center systematically reviewed evidence on factors associated with outcomes among individuals with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) and whether outcomes differed by sociodemographic characteristics.
METHOD
We searched electronic databases including MEDLINE and reviewed studies published from 1980 to September, 2005, in all languages against a priori inclusion/exclusion criteria and focused on eating, psychiatric or psychological, or biomarker outcomes.
RESULTS
At followup, individuals with AN were more likely than comparisons to be depressed, have Asperger's syndrome and autism spectrum disorders, and suffer from anxiety disorders including obsessive-compulsive disorders. Mortality risk was significantly higher than what would be expected in the population and the risk of suicide was particularly pronounced. The only consistent factor across studies relating to worse BN outcomes was depression. A substantial proportion of individuals continue to suffer from eating disorders over time but BN was not associated with increased mortality risk. Data were insufficient to draw conclusions concerning factors associated with BED outcomes. Across disorders, little to no data were available to compare results based on sociodemographic characteristics.
CONCLUSION
The strength of the bodies of literature was moderate for factors associated with AN and BN outcomes and weak for BED.
Topics: Feeding and Eating Disorders; Humans; Treatment Outcome
PubMed: 17370291
DOI: 10.1002/eat.20369 -
Frontiers in Human Neuroscience 2014In his first description of Autism Spectrum Disorders (ASD), Kanner emphasized emotional impairments by characterizing children with ASD as indifferent to other people,... (Review)
Review
In his first description of Autism Spectrum Disorders (ASD), Kanner emphasized emotional impairments by characterizing children with ASD as indifferent to other people, self-absorbed, emotionally cold, distanced, and retracted. Thereafter, emotional impairments became regarded as part of the social impairments of ASD, and research mostly focused on understanding how individuals with ASD recognize visual expressions of emotions from faces and body postures. However, it still remains unclear how emotions are processed outside of the visual domain. This systematic review aims to fill this gap by focusing on impairments of emotional language processing in ASD. We systematically searched PubMed for papers published between 1990 and 2013 using standardized search terms. Studies show that people with ASD are able to correctly classify emotional language stimuli as emotionally positive or negative. However, processing of emotional language stimuli in ASD is associated with atypical patterns of attention and memory performance, as well as abnormal physiological and neural activity. Particularly, younger children with ASD have difficulties in acquiring and developing emotional concepts, and avoid using these in discourse. These emotional language impairments were not consistently associated with age, IQ, or level of development of language skills. We discuss how emotional language impairments fit with existing cognitive theories of ASD, such as central coherence, executive dysfunction, and weak Theory of Mind. We conclude that emotional impairments in ASD may be broader than just a mere consequence of social impairments, and should receive more attention in future research.
PubMed: 25610383
DOI: 10.3389/fnhum.2014.00991 -
Revista de NeurologiaAnalysis of nocturnal sleep in infantile autism has been presented in various studies. However, there has been no systematization including the different structural and... (Review)
Review
INTRODUCTION
Analysis of nocturnal sleep in infantile autism has been presented in various studies. However, there has been no systematization including the different structural and paroxystic alterations at the same time as permitting the development of a general theory of the effect of sleep on prognosis and treatment, particularly in a spectrum in which there is currently no definite solution.
DEVELOPMENT
A systematic review was made of the literature obtained from publications included in MEDLINE and web pages of the last 25 years using the key words: autism, Asperger's disorder, sleep, childhood and Rett's syndrome. Altogether 21 papers fulfllled criteria for inclusion. Disorders of sleep in infantile autism were classified into three types: immaturity of sleep, showing a destructured polysomnographic recording and negative correlation with the level of development; functional alterations of sleep with early waking and difficulty in going to sleep being the disorders most frequently seen; and paroxystic alterations with epileptiform discharges being the commonest, without necessarily occurring together with seizures. The opinions stated on questionnaires and the data observed on the polysomnography were not in agreement.
CONCLUSIONS
Analysis of the literature has permitted us to make an initial classification of sleep disorders in autistic children, and has shown a marked presence of these disorders in the evolution of autistic children. It is necessary that further studies being done, polysomnographic rather than by means of questionnaires, for two reasons: clinical and in order to obtain more precise classification.
Topics: Autistic Disorder; Electroencephalography; Humans; MEDLINE; Polysomnography; Sleep; Sleep Wake Disorders
PubMed: 11391493
DOI: No ID Found -
L'Encephale Apr 2024Humor is essential to social relationships. Its use and understanding appear to be impaired in people with Autism Spectrum Disorder (ASD). The main objective was to...
OBJECTIVES
Humor is essential to social relationships. Its use and understanding appear to be impaired in people with Autism Spectrum Disorder (ASD). The main objective was to review the existing literature on the detection, understanding and use of humor in persons with ASD. The secondary objective involved exploring assessment scales and specific intervention tools.
METHODS
A systematic review of the literature was carried out on all available French and English scientific papers about humor - including irony - in persons with ASD up to November 2021. We extracted 552 references and included 43 articles from six databases.
RESULTS
Studies suggest that those with ASD can detect audiovisual and written humor. Understanding humor was impaired in writing and when using pure auditory stimuli and non-verbal cartoons. For irony, the results indicated a lower detection of quality and less understanding in speaking but not in writing. Regarding its use, in terms of expression, people with ASD use benevolent humor less often and do not consider humor as a key source of satisfaction with life, as opposed to the control group.
CONCLUSIONS
It appears that it would be worthwhile to develop standardized humor detection and assessment tools specific to persons with ASD. Practical strategies that focus on humor ability could be worth developing, either individually or in groups.
Topics: Humans; Autism Spectrum Disorder; Interpersonal Relations
PubMed: 38176977
DOI: 10.1016/j.encep.2023.10.002 -
Journal of Psychiatric Research Oct 2022Oxytocin (OXT) is a hypothalamic neuropeptide that is released from the posterior pituitary gland and at specific targets in the central nervous system (CNS). The... (Review)
Review
PURPOSE
Oxytocin (OXT) is a hypothalamic neuropeptide that is released from the posterior pituitary gland and at specific targets in the central nervous system (CNS). The prosocial effects of OXT acting in the CNS present it as a potential therapeutic agent for the treatment of aspects of autism spectrum disorder (ASD). In this article, we systematically review the functional MRI (fMRI) literature that reports task-state and resting-state fMRI (rsfMRI) studies of the neural effects of single or multiple dose intranasal OXT (IN-OXT) administration in individuals with ASD.
METHOD
We searched four databases for relevant documents (PubMed, Web of Science, Scopus, and Google Scholar) using the keywords "autism spectrum disorder", "Asperger Syndrome", "oxytocin", and "fMRI". Moreover, we made a manual search to assess the quality of our automatic search. The search was confined to English language articles published in the interval February 2013 until March 2021.
RESULTS
The search yielded 12 fMRI studies with OXT intervention, including 288 individuals with ASD (age 8-55 years) enrolled in randomized, double-blind, placebo-controlled, parallel designs, within-subject-crossover experimental OXT trials. Studies reporting activation task and rsfMRI were summarized with region of interest (ROI) or whole-brain voxel wise analysis. The systematic review of the 12 studies supported the proposition that IN-OXT administration alters brain activation in individuals with ASD. The effects of IN-OXT interacted with the type of the task and the overall results did not indicate restoration of normal brain activation in ASD signature regions albeit the lack of statistical evidence.
CONCLUSION
A large body of evidence consistently indicates that OXT alters activation to fMRI in brain networks of individuals with ASD, but with uncertain implications for alleviation of their social deficits.
Topics: Administration, Intranasal; Adolescent; Adult; Autism Spectrum Disorder; Autistic Disorder; Child; Humans; Magnetic Resonance Imaging; Middle Aged; Oxytocin; Randomized Controlled Trials as Topic; Young Adult
PubMed: 35933858
DOI: 10.1016/j.jpsychires.2022.06.033 -
Autism : the International Journal of... Oct 2015Autism spectrum disorders are characterised by impairments in communication and social interaction. Social skills interventions have been found to ameliorate... (Review)
Review
Autism spectrum disorders are characterised by impairments in communication and social interaction. Social skills interventions have been found to ameliorate socio-communication deficits in children and adolescents with autism spectrum disorders. Little is known about the effectiveness of social skills interventions for adults with high-functioning autism spectrum disorders (hf-ASD) - a clinical population who can present with more subtle core deficits, but comparable levels of impairment and secondary difficulties. A systematic review was undertaken to investigate the effectiveness of social skills interventions for adults with high-functioning autism spectrum disorders. Five studies met the pre-specified review inclusion criteria: two quasi-experimental comparative trials and three single-arm interventions. There was a degree of variation in the structure, duration and content of the social skills interventions delivered, as well as several methodological limitations associated with included studies. Nevertheless, narrative analysis tentatively indicates that group social skills interventions may be effective for enhancing social knowledge and understanding, improving social functioning, reducing loneliness and potentially alleviating co-morbid psychiatric symptoms.
Topics: Adult; Autism Spectrum Disorder; Humans; Psychotherapy, Group; Social Skills
PubMed: 26045543
DOI: 10.1177/1362361315587659