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Journal of Affective Disorders Feb 2023Changes in the brain's default mode network (DMN) in the resting state are closely related to autism spectrum disorder (ASD). Module segmentation can effectively...
Changes in the brain's default mode network (DMN) in the resting state are closely related to autism spectrum disorder (ASD). Module segmentation can effectively elucidate the neural mechanism of ASD and explore intra- and inter-network connections by means of the participation coefficient (PC). We used that resting-state fMRI data from 269 ASD patients and 340 healthy controls (HCs) in the current study. From the results, ASD subjects showed a significantly higher PC of the DMN than HC subjects. This difference was related to lower intra-module connections within the DMN and higher inter-network connections between the DMN and other networks. When the subjects were split into age groups, the results were verified in the 7-12- and 12-18-year-old age groups but not in the young adult group (18-25 years). When the subjects were divided according to different subtypes of ASD, the results were also observed in the classic autism and pervasive developmental disorder groups, but not in the Asperger disorder group. In conclusions, less developed network segregation in the DMN could be a valid biomarker for ASD. This provides network scientists with new insights into the intermodular connectivity configurations of complex networks from different dimensions in a systematic and comprehensive manner.
Topics: Young Adult; Humans; Autism Spectrum Disorder; Brain; Brain Mapping; Default Mode Network; Neural Pathways; Magnetic Resonance Imaging
PubMed: 36455716
DOI: 10.1016/j.jad.2022.11.083 -
The Lancet. Psychiatry Dec 2022To make decisions in mental health care, service users, clinicians, and administrators need to make sense of research findings. Unfortunately, study results are often... (Review)
Review
To make decisions in mental health care, service users, clinicians, and administrators need to make sense of research findings. Unfortunately, study results are often presented as raw questionnaire scores at different time points and regression coefficients, which are difficult to interpret with regards to their clinical meaning. Other commonly reported treatment outcome indicators in clinical trials or meta-analyses do not convey whether a given change score would make a noticeable difference to service users. There is an urgent need to improve the interpretability and relevance of outcome indicators in youth mental health (aged 12-24 years), in which shared decision making and person-centred care are cornerstones of an ongoing global transformation of care. In this Personal View, we make a case for considering minimally important change (MIC) as a meaningful, accessible, and user-centred outcome indicator. We discuss what the MIC represents, how it is calculated, and how it can be implemented in dialogues between clinician and researcher, and between youth and clinician. We outline how use of the MIC could enhance reporting in clinical trials, meta-analyses, clinical practice guidelines, and measurement-based care. Finally, we identify current methodological challenges around estimating the MIC and areas for future research. Efforts to select outcome domains and valid measurement instruments that resonate with youth, families, and clinicians have increased in the past 5 years. In this context, now is the time to define demarcations of changes in outcome scores that are clinically relevant, and meaningful to youth and families. Through the use of MIC, youth-centred outcome measurement, analysis, and reporting would support youth-centred therapeutic decision making.
Topics: Humans; Adolescent; Mental Health; Surveys and Questionnaires; Treatment Outcome; Decision Making, Shared; Longitudinal Studies
PubMed: 36403601
DOI: 10.1016/S2215-0366(22)00338-8 -
Acta Paediatrica (Oslo, Norway : 1992) May 2023Hans Asperger is probably best known for Asperger syndrome. However, he has been accused of knowingly and willingly participating in the National Socialist Child...
AIM
Hans Asperger is probably best known for Asperger syndrome. However, he has been accused of knowingly and willingly participating in the National Socialist Child Euthanasia programme by referring patients to the Am Spiegelgrund children's home in Vienna. This later became notorious for euthanising disabled children. We investigated those allegations.
METHODS
Clinicians and historians examined original documents and transcripts related to Asperger's referrals from the Viennese Therapeutic Pedagogy Unit, and corresponding Am Spiegelgrund admissions, up to 25 March 1943, when he was drafted.
RESULTS
Asperger referred 13 children to Am Spiegelgrund. Eleven survived and apparently received adequate care that allowed them to achieve positive developments, but two girls died. Asperger referred these two girls during June and October 1941, before most of the deaths at Am Spiegelgrund occurred and before its euthanasia programme became public knowledge. Our detailed investigation of the medical records, Unit referral practices and Am Spiegelgrund provided no evidence that Asperger knew about the euthanasia programme at the time of the referrals. One death was probably due to euthanasia, but the other was less clear.
CONCLUSION
There was no evidence that Asperger knew about the euthanasia programme when he referred two patients who died at Am Spiegelgrund.
Topics: Male; Female; Humans; Child; Asperger Syndrome; National Socialism; Disabled Children; Euthanasia; Occupations
PubMed: 36239413
DOI: 10.1111/apa.16571 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022To study atypical eating behavior (AEB) in various variants of autism spectrum disorder (ASD) to determine the prognosis and therapeutic tactics.
OBJECTIVE
To study atypical eating behavior (AEB) in various variants of autism spectrum disorder (ASD) to determine the prognosis and therapeutic tactics.
MATERIAL AND METHODS
One hundred and eighty patients (110 girls, 70 boys), aged 2 to 5 years (mean age 4 years), with a diagnosis of «Childhood autism» (F84.02), «Atypical autism» (F84.1), «Asperger Syndrome» (F84.5) and the presence of AEB were examined.
RESULTS
Three clinical variants of ASD accompanied by AEB were identified: catatonic-regressive (75, 41%), catatonic (81, 45%) and hyperdynamic (24, 13%). The most pronounced AEB were in the catatonic-regressive variant, and the least in the hyperdynamic variant of ASD. The severity of AEB is associated with the severity of cognitive dysontogenesis.
CONCLUSION
The characteristics of AEB are associated with the leading clinical syndrome of ASD. The severity of catatonia and regression affects the depth of AEB, which leads to secondary somatic disorders. Specialists of various profiles should participate in medical work for successful rehabilitation and prevention of somatic complications.
Topics: Autism Spectrum Disorder; Autistic Disorder; Catatonia; Child; Child, Preschool; Feeding Behavior; Female; Humans; Male; Prognosis
PubMed: 36170098
DOI: 10.17116/jnevro202212209242 -
Nature Oct 2022
PubMed: 36151472
DOI: 10.1038/s41586-022-05300-0 -
Annali Dell'Istituto Superiore Di Sanita 2022To identify developmental symptoms reported at firsts doctor visits by parents of children later diagnosed with Autism Spectrum Disorder (ASD).
OBJECTIVE
To identify developmental symptoms reported at firsts doctor visits by parents of children later diagnosed with Autism Spectrum Disorder (ASD).
DESIGN
Cohort study.
SETTING
The study was conducted in the Department of Psychiatry Research of "Prof. Dr. Alexandru Obregia" Clinical Psychiatry Hospital from Bucharest between September 2019 and May 2021.
PATIENTS
105 cases: 82 boys and 23 girls, 100 children with autism, and 5 patients with Asperger's syndrome.
INTERVENTION
ASD was diagnosed according to the DSM-5 criteria, ADOS-1 (Autism Diagnostic Observation Schedule, 1st Edition) and/or ADI-R (Autism Diagnostic Interview-Revised) tests scores; features reported by the parents for which they presented to the doctor for a diagnosis were taken into consideration.
MAIN OUTCOME MEASURES
The age at first presentation to the doctor; the most common early signs reported by the parents of children with ASD.
RESULTS
The age at first presentation to the doctor in our group was between 9 months and 14 years. The most common early signs reported by parents were: delayed language development, deficits in understanding verbal instructions/indications, and hyperactivity and aggressivity. In the case of patients with Asperger's syndrome, the reported features were hyperactivity and aggressivity, learning difficulties, and social interaction problems. Regression and delay in language development occurred more often in boys than in girls.
CONCLUSIONS
Parents, as well as family doctors or paediatricians, should pay great attention to the children's behaviour, alongside their cognitive and language development. Early detection is essential for early intervention and our results can be used to develop training programs for parents and paediatricians for early recognition of ASD.
Topics: Autism Spectrum Disorder; Child; Cohort Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Infant; Male; Parents
PubMed: 36128967
DOI: 10.4415/ANN_22_03_07 -
Acta Bio-medica : Atenei Parmensis Aug 2022Schools play a key role in detecting early signs of autism and creating a targeted pathway of study and inclusion. This becomes complicated when faced with unknown...
Autism Spectrum Disorders and inclusion attitudes in the Italian school environments: teachers' knowledge, attitudes, perceptions and their necessity to consult a healthcare multidisciplinary team.
BACKGROUND
Schools play a key role in detecting early signs of autism and creating a targeted pathway of study and inclusion. This becomes complicated when faced with unknown situations, such as managing a student with Autism Spectrum Disorders (ASD).
MATERIALS AND METHODS
A nationwide study involving teachers (n=235) was conducted from March to August 2021. The survey instrument consisted of a questionnaire administered online through social networks containing socio-demographic data, attitudes, knowledge and inclusion plans from school teachers towards students with ASD.
RESULTS
Statistical significant differences were registered for the item no.13: among the main deficits caused by ADS are reduced social cognition, language abnormalities, and impaired sensory functioning. (p=.025); the item no.8 (p=.011): if an intervention works for one child with ASD, it is certain to work on another child with ASD; the item no.3(p=.002): genetic factors play an important role in the causes of ASD. By also considering teacher's attitudes towards ASD according to the presence of a healthcare worker in the school environment, significant differences were registered for the item no.1 (p=.032): the interpretation that the diagnostic criteria for Asperger's syndrome are the same as for high-functioning autism; the item no.6 (p=.025): children with ADS are very similar to each other, and the item no.7(p=.015): early intervention does not lead to additional benefits for children with ASD.
CONCLUSIONS
The presence of professionals with advanced skills could be a benefit and represent a strong point in the application of measures of prevention and containment of community pathologies.
Topics: Autism Spectrum Disorder; Child; Health Knowledge, Attitudes, Practice; Humans; Language; Patient Care Team; School Teachers
PubMed: 36043964
DOI: 10.23750/abm.v93i4.12938 -
Turkish Journal of Ophthalmology Aug 2022The purpose of this study was to describe the ophthalmologic manifestations found in patients with autism spectrum disorder (ASD) and to assess their prevalence in the... (Observational Study)
Observational Study
OBJECTIVES
The purpose of this study was to describe the ophthalmologic manifestations found in patients with autism spectrum disorder (ASD) and to assess their prevalence in the different types of ASD.
MATERIALS AND METHODS
This prospective observational study included 344 patients with ASD seen over a period of 8.5 years. They were classified into four subgroups (autism, Asperger syndrome, pervasive developmental disorders not otherwise specified [PDD-NOS], and other). Data obtained from ophthalmological examinations were compared between the groups. Statistical analysis was performed with chi-square, Kruskal-Wallis, and Mann-Whitney tests.
RESULTS
Refractive defects were detected in 48.4% of the patients, with the most prevalent being hyperopia and astigmatism. There was a higher prevalence of myopia in Asperger syndrome. Evaluation of extraocular motility revealed the presence of strabismus in 15.4% of patients, with a statistically significantly higher prevalence in autism and the "other" disorders group. The most frequent type of strabismus was exotropia. Convergence was found to be normal in 43.6% of the patients. Nystagmus was observed in only 0.9% of patients. In the binocular sensory tests performed, patients with Asperger syndrome had significantly better results compared to the other groups. Optic nerve abnormalities were found in 4% of patients, with significantly higher prevalence in the "other" disorders group.
CONCLUSION
Ophthalmologic manifestations occur more frequently in patients with ASD than in the general child population. Of these, the most frequent are refractive defects and ocular motility disorder. Therefore, we consider it necessary to perform an ophthalmological evaluation in patients with ASDs.
Topics: Autism Spectrum Disorder; Autistic Disorder; Child; Humans; Prevalence; Refraction, Ocular; Strabismus
PubMed: 36016969
DOI: 10.4274/tjo.galenos.2021.46588 -
Innovations in Clinical Neuroscience 2022Autism spectrum disorders (ASDs) are a group of neurodevelopmental pathologies characterized by social and communication deficits, for which treatments are limited. Cell...
Autism spectrum disorders (ASDs) are a group of neurodevelopmental pathologies characterized by social and communication deficits, for which treatments are limited. Cell therapies, including intrathecal (IT) administration of bone marrow (BM) mononuclear cells (BM-MNC), improves symptoms in patients with ASD. Twenty-four patients diagnosed with ASD, according to the (DSM-IV-TR) criteria, were autologously treated with IT BM-MNC, and the clinical effect was evaluated using the Childhood Autism Rating Scale (CARS) on Days 30 (n=24) and 180 (n=14) post-treatment. IT BM-MNC improved clinical outcomes by Day 30 (=0.0039), and those benefits remained and were further accentuated by Day 180 post-treatment (n=14; =<0.0001). Clinical benefit at Days 30 (=0.001; r= -0.51) and 180 (=0.01; r= -0.60) posttreatment positively correlated with the enrichment of a putative BM stem cell population expressing the cluster of differentiation 133+ (CD133+) surface marker.
PubMed: 35958968
DOI: No ID Found -
International Journal of Environmental... Aug 2022Self-report measures are central in capturing young people's perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such...
Self-report measures are central in capturing young people's perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such measures meaningfully and independently, the reading difficulty must match their reading ability. Prior research suggests a frequent mismatch for mental health symptom measures. Similar analyses are lacking for measures of Quality of Life (QoL). We analysed the readability of 13 commonly used QoL self-report measures for children and adolescents aged 6 to 18 years by computing five readability formulas and a mean reading age across formulas. Across measures, the mean reading age for item sets was 10.7 years (SD = 1.2). For almost two-thirds of the questionnaires, the required reading age exceeded the minimum age of the target group by at least one year, with an average discrepancy of 3.0 years (SD = 1.2). Questionnaires with matching reading ages primarily targeted adolescents. Our study suggests a frequent mismatch between the reading difficulty of QoL self-report measures for pre-adolescent children and this group's expected reading ability. Such discrepancies risk undermining the validity of measurement, especially where children also have learning or attention difficulties. Readability should be critically considered in measure development, as one aspect of the content validity of self-report measures for youth.
Topics: Adolescent; Child; Comprehension; Humans; Quality of Life; Reading; Self Report; Treatment Outcome
PubMed: 35954923
DOI: 10.3390/ijerph19159555