Autism Research最新文献

Of the 1 in 36 individuals in the United States who are diagnosed with autism spectrum disorder, nearly 40% also have intellectual disability (ID). The cortex has been widely implicated in neural processes underlying autistic behaviors as well as intellectual ability. Thus, neuroimaging features such as cortical thickness are of particular interest as a possible biomarkers of the condition. However, neuroimaging studies often fail to include autistic individuals with ID. As a result, there are few studies of cortical thickness in autistic individuals across the entire range of intellectual abilities. This study used MRI to evaluate cortical thickness in young autistic children (n = 88, mean age 5.37 years) with a large range of intellectual ability (IQ 19–133) as well as nonautistic, nondevelopmentally delayed (referred to here as typically developing [TD]) peers (n = 53, mean age 5.29 years). We first investigated associations between full scale IQ and cortical thickness in both autistic and TD children. Autistic children had significant negative associations (i.e., thinner cortex, higher IQ) in bilateral entorhinal cortex, right fusiform gyrus, superior, middle and inferior temporal gyri, and right temporal pole that were not present in TD children. Significantly thicker cortex was also observed in these regions for autistic children with ID (i.e., IQ ≤ 70) compared with those without. Last, given the reported correspondence between the severity of autism symptoms and intellectual ability, we compared cortical thickness associations with both IQ and ADOS Calibrated Severity Scores and found these patterns overlapped to a significant degree across the cortex.

Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1, 2021 to May 31, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression—Improvement (CGI-I) were collected. Forty-five autistic patients with co-morbid catatonia were treated during the study period. The mean age was 15.6 (SD = 7.9) years [Mdn = 16.0, range 6.0–31.0]. Forty-one patients (91.1%) met criteria for autism with co-occurring intellectual disability. All patients received pharmacotherapy. Forty-four (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD = 15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Sixteen (35.6%) patients received electroconvulsive therapy. Fourteen patients (31.1%) attempted to taper off benzodiazepines after achieving clinical improvement during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained at least partially symptomatic over the study period. Three patients (6.7%) died over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment. Notably, the open label design of this study is a limiting factor when interpreting the results.

This study explored gross motor development (GMD) trajectories among 6359 children, with and without autism, from the Growing Up in New Zealand longitudinal cohort study. By the age of 8, 173 children had either an autism diagnosis (n = 108) or parent-reported autism concerns (n = 65). Gross motor milestones were reported by mothers when children were 9, 24, and 54 months of age. We found that irrespective of autism diagnosis, GMD delays at 24 months of age were more likely among girls, children born preterm, and those whose mothers identified as European. A mixed-effect logistic regression model, controlling for antenatal maternal and child covariates, revealed that the proportion of children with GMD delay (relative to their peers) increased significantly from 9 to 54 months for all three groups, but the increase was greater for those with autism concerns (OR = 1.28, 95% CI = 1.08–1.52) or an autism diagnosis (OR = 1.26, 95% CI = 1.10–1.43) compared to the no autism group (OR = 1.06, 95% CI = 1.02–1.10). Differences in the changes in GMD performance among children with an autism diagnosis compared to those without autism occurred between 9 and 24 months (OR = 2.16, 95% CI = 1.13–4.13). No significant GMD delay differences were found at any time between children with an autism diagnosis versus those with autism concerns. Children with a GMD delay should be screened for autism at 24 m. Early identification is the first step toward knowledge-based, effective intervention of developmental difficulties.

Children with autism spectrum disorder (ASD) display a variety of core and co-occurring difficulties in social, communication, everyday functioning, cognitive, motor, and language domains. Receiving a combination of services to accommodate needs of autistic individuals is essential for improving their future outcomes. During the COVID-19 pandemic, reduced service access negatively impacted autistic children's outcomes. This study aimed to examine the relationship between service receipt and parental perceived outcomes in autistic children while accounting for various demographic, child, and parental factors. We utilized parental COVID-19 impact survey data from the SPARK study (N = 6067). Ordinal logistic regression analyses were used to predict perceived child outcomes. Demographic, child, and parental factors were included in the prediction models. Service receipt of SLT, ABA, PT/OT, MED, and MH were associated with perceived child outcomes. PT/OT and ABA predicted improvements in domains of social interaction, everyday activity, and overall autism severity; SLT and ABA contributed to improved perceived communication outcomes. Receiving MH and MED services was associated with worsening of perceived outcomes on all domains. Younger age, males, higher family income, lower autism severity, lower motor, function, and cognitive delay, greater language delay, and the absence of parental mental health issues were associated with greater improvements in various perceived outcomes. Overall, PT/OT and ABA services are associated with improved perceived social and functional outcomes whereas SLT and ABA services are associated with improved perceived communication outcomes. We also provide a wholistic view of factors affecting relationships between service receipt and perceived child outcomes during the pandemic.

The cerebellum plays a crucial role in functions, including sensory-motor coordination, cognition, and emotional processing. Compared to the neocortex, the human cerebellum exhibits a protracted developmental trajectory. This delayed developmental timeline may lead to increased sensitivity of the cerebellum to external influences, potentially extending the vulnerability period for neurological disorders. Abnormal cerebellar development in individuals with autism has been confirmed, and these atypical cerebellar changes may affect the development of the neocortex. However, due to the heterogeneity of autism spectrum disorder (ASD), the regional changes in the cerebellum and cerebellocerebral structural relationship remain unknown. To address these issues, we utilized imaging methods optimized for the cerebellum and cerebrum on 817 individuals aged 5–18 years in the ABIDE II dataset. After FDR correction, significant differences between groups were found in the right crus II/VIIB and vermis VI-VII. Structural covariance analysis revealed enhanced structural covariance in individuals with autism between the cerebellum and parahippocampal gyrus, pars opercularis, and transverse temporal gyrus in the right hemisphere after FDR correction. Furthermore, the structural covariance between the cerebellum and some regions of the cerebrum varied across sexes. A significant increase in structural covariance between the cerebellum and specific subcortical structures was also observed in individuals with ASD. Our study found atypical patterns in the structural covariance between the cerebellum and cerebrum in individuals with autism, which suggested that the underlying pathological processes of ASD might concurrently affect these brain regions. This study provided insight into the potential of cerebellocerebral pathways as therapeutic targets for ASD.