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Autologous umbilical cord blood infusion for the treatment of autism in young children: A within-subjects open label study on safety (assessed via caregiver report) and efficacy 自体脐带血输注治疗幼儿自闭症:关于安全性(通过护理人员报告进行评估)和疗效的受试者内开放标签研究。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-29 DOI: 10.1002/aur.3187
Chui Mae Wong, Charmain Samantha Tan, Natasha Riard, Yeleswarapu Sita Padmini, Lourdes Mary Daniel, Arun Prasath, Ah. Moy Tan, Thiam Chye Tan, Rehena Sultana, Joyce Ching Mei Lam

This study aimed to document the safety and efficacy of a single infusion of autologous umbilical cord blood (UCB) in 20 autistic children aged 24–72 months. A pre-post treatment within-subjects open label design was used. At T = 0, 6, 12, and 18 months, participants underwent detailed and structured safety evaluations (via caregiver report), Vineland Adaptive Behavior Scale (Vineland-3), Stanford Binet Intelligence Scale (SB-5), Expressive One-Word Picture Vocabulary Test, Brief Observation of Social Communication Change (BOSCC), Pervasive Developmental Disorder-Behavior Inventory, Repetitive Behavior Scale-Revised, Sensory Experience Questionnaire (SEQ-2.1), Child Behavior Checklist, Clinical Global Impression-Severity and Improvement (CGI-I) Scales, and eye-gaze tracking. UCB infusion was conducted at T = 6 months, hence, 0–6 months was the control period, and 6–18 months the follow-up period. Of 20 children recruited, 19 completed the study and 1 was withdrawn due to UCB not meeting quality control criteria for infusion. There were 15 males and 4 females with an overall mean (SD) age of 4.15 (0.62) years. Mean (SD) cell dose administered was 38.16 (9.82) million cells/kg. None suffered serious adverse events although there were mild behavioral side effects and one unit grew coagulase negative staphylococcus from a post-thaw sample. There were no significant differences in Vineland-3, SB-5, BOSCC, and SEQ-2.1 scores at T = 12 and T = 18 months. Twelve participants had T = 18 CGI-I scores of 2–3 (minimally to much improved), seven participants had scores of 4 (no change). Autologous UCB infusion in autistic children is generally safe but not without risks, including that of infection. In this within-subjects study, some children showed global symptom improvements while others showed no change. Stem cell therapies for autism should only be conducted under strict clinical trial conditions with clear risk discussions.

本研究旨在记录单次输注自体脐带血(UCB)对 20 名 24-72 个月自闭症儿童的安全性和有效性。研究采用受试者内前-后治疗开放标签设计。在 T = 0、6、12 和 18 个月时,参与者接受了详细的结构化安全评估(通过护理人员报告)、文兰适应行为量表 (Vineland-3)、斯坦福比奈智力测验量表 (SB-5)、单字图画词汇表达能力测试、社会交流变化简要观察 (BOSCC)、广泛性发育障碍行为量表、重复行为量表-修订版、感官体验问卷 (SEQ-2. 1)、儿童行为问卷 (SEQ-2. 1)、自闭症儿童行为问卷 (SEQ-2. 1)。1)、儿童行为核对表、临床整体印象-严重程度和改善程度(CGI-I)量表以及眼动跟踪。UCB 输注在 T = 6 个月时进行,因此 0-6 个月为对照期,6-18 个月为随访期。在招募的 20 名儿童中,19 人完成了研究,1 人因 UCB 不符合输注质量控制标准而退出。其中男性 15 人,女性 4 人,平均(标清)年龄为 4.15(0.62)岁。平均(标清)细胞剂量为 38.16 (9.82) 百万细胞/公斤。虽然出现了轻微的行为副作用,有一个单位在解冻后的样本中长出了凝固酶阴性葡萄球菌,但没有出现严重的不良反应。在 T = 12 个月和 T = 18 个月时,Vineland-3、SB-5、BOSCC 和 SEQ-2.1 评分无明显差异。12名参与者在T = 18时的CGI-I评分为2-3分(略有改善到大有改善),7名参与者的评分为4分(无变化)。自闭症儿童的自体 UCB 输注通常是安全的,但也不是没有风险,包括感染风险。在这项受试者内部研究中,一些儿童的症状得到全面改善,而另一些则没有变化。治疗自闭症的干细胞疗法只能在严格的临床试验条件下进行,并进行明确的风险讨论。
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引用次数: 0
Parent–infant interaction trajectories in infants with an elevated likelihood for autism in relation to 3-year clinical outcome 自闭症高危婴儿的亲子互动轨迹与 3 年临床结果的关系。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-28 DOI: 10.1002/aur.3190
Eirini Papageorgopoulou, Emily J. H. Jones, Mark H. Johnson, Tony Charman, Jonathan Green, Ming Wai Wan, The BASIS-STAARS Team

Developmental antecedents of autism may affect parent–infant interactions (PII), altering the context in which core social skills develop. While studies have identified differences in PII between infants with and without elevated likelihood (EL) for autism, samples have been small. Here, we examined whether previously reported differences are replicable. From a longitudinal study of 113 EL and 27 typical likelihood infants (TL), 6-min videotaped unstructured PII was blind rated at 8 and 14 months on eight interactional qualities. Autism outcome was assessed at 36 months. Linear mixed-effects models found higher parent sensitive responsiveness, nondirectiveness, and mutuality ratings in TL than EL infants with and without later autism. PII qualities at 8 (infant positive affect, parent directiveness) and 14 months (infant attentiveness to parent, mutuality) predicted 3-year autism. Attentiveness to parent decreased between 8 and 14 months in EL infants with later autism. This larger study supports previous findings of emerging alterations in PII in this group and extends on this by detecting earlier (8-month) predictive effects of PII for autism outcome and a more marked trajectory of decreased social attentiveness. The findings strengthen the evidence base to support the implementation of early preemptive interventions to support PII in infants with early autism signs.

自闭症的发育先兆可能会影响父母与婴儿之间的互动(PII),从而改变核心社交技能的发展环境。虽然已有研究发现患有自闭症和未患有自闭症的婴儿在亲子互动方面存在差异,但这些研究的样本都很小。在此,我们研究了之前报道的差异是否可以复制。在一项针对 113 名 EL 婴儿和 27 名典型 EL 婴儿(TL)的纵向研究中,我们分别在婴儿 8 个月和 14 个月时对 8 种互动品质进行了 6 分钟非结构化 PII 盲评。自闭症结果在 36 个月时进行评估。线性混合效应模型发现,与 EL 婴儿相比,TL 婴儿的父母敏感反应度、非指导性和相互性评分均高于 EL 婴儿,无论其日后是否患有自闭症。8 个月(婴儿的积极情绪、父母的直接性)和 14 个月(婴儿对父母的专注度、相互性)时的 PII 质量可预测 3 年的自闭症。患有日后自闭症的 EL 婴儿在 8 个月至 14 个月期间对父母的关注度有所下降。这项规模更大的研究证实了之前的研究结果,即自闭症婴儿的 PII 出现了新的变化,并通过检测 PII 对自闭症结果的早期(8 个月)预测效应和更明显的社会关注度下降轨迹,对这一研究结果进行了扩展。这些发现加强了证据基础,支持对有早期自闭症征兆的婴儿实施早期预防性干预,以支持他们的 PII。
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引用次数: 0
Early developmental milestone clusters of autistic children based on electronic health records 基于电子健康记录的自闭症儿童早期发展里程碑群。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-26 DOI: 10.1002/aur.3177
Ayelet Ben-Sasson, Joshua Guedalia, Keren Ilan, Galit Shefer, Roe Cohen, Lidia V. Gabis

Autistic children vary in symptoms, co-morbidities, and response to interventions. This study aimed to identify clusters of autistic children with a distinct pattern of attaining early developmental milestones (EDMs). The clustering of 5836 autistic children was based on the attainment of 43 gross motor, fine motor, language, and social developmental milestones during the first 3 years of life as recorded in baby wellness visits. K-means cluster analysis detected four EDM clusters: mild (n = 1686); moderate (n = 1691); severe (n = 2265); and global (n = 194). The most prominent cluster differences were in the language domain. The global cluster showed earlier and greater developmental delay across domains, unique early gross motor delays, and more were born preterm via cesarean section. The severe cluster had poor language development prominently in the second year of life, and later fine motor delays. Moderate cluster had mainly language delays in the third year of life. The mild cluster mostly passed milestones. EDM clusters differed demographically, with higher socioeconomic status in mild cluster and lowest in global cluster. However, the severe cluster had more immigrant and non-Jewish mothers followed by the moderate cluster. The rates of parental concerns and provider developmental referrals were significantly higher in the global, followed by the severe, moderate, and mild EDM clusters. Autistic children's language and motor delay in the first 3 years can be grouped by common magnitude and onset profiles as distinct groups that may link to specific etiologies (like prematurity or genetics) and specific intervention programs. Early autism screening should be tailored to these different developmental profiles.

自闭症儿童的症状、并发症和对干预措施的反应各不相同。本研究旨在找出在实现早期发育里程碑(EDMs)方面具有独特模式的自闭症儿童群组。对5836名自闭症儿童进行聚类的依据是婴儿健康访视中记录的他们在出生后头3年中达到的43个粗大运动、精细运动、语言和社交发展里程碑。K-means 聚类分析发现了四个 EDM 聚类:轻度(n = 1686)、中度(n = 1691)、重度(n = 2265)和全面(n = 194)。最突出的群组差异出现在语言领域。全面组的儿童在各个领域的发育迟缓更早、更严重,早期粗大运动发育迟缓也很独特,而且更多的儿童是通过剖腹产早产的。重度群组的语言发展较差,主要表现在出生后第二年,随后出现精细动作发育迟缓。中度组主要在出生后第三年出现语言发育迟缓。轻度组的孩子大多通过了里程碑。EDM 组群在人口统计学上存在差异,轻度组群的社会经济地位较高,而重度组群的社会经济地位最低。然而,重度组的母亲多为移民和非犹太人,中度组次之。家长的担忧和提供者的发展转介率在总体群组中明显较高,其次是重度、中度和轻度 EDM 群组。自闭症儿童在头 3 年的语言和运动发育迟缓可根据共同的程度和发病特征分为不同的组别,这些组别可能与特定的病因(如早产或遗传)和特定的干预计划有关。早期自闭症筛查应针对这些不同的发育特征。
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引用次数: 0
Balance and motor skills differences between children and teenagers with autism spectrum disorder and neurotypically developing 自闭症谱系障碍儿童和青少年与神经发育正常儿童和青少年在平衡和运动技能方面的差异。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-25 DOI: 10.1002/aur.3181
Paloma Martín-Díaz, Alicia Cuesta-Gómez, Pilar Fernádez-González, María Carratlá-Tejada

This study examined the differences between children and adolescents with autism spectrum disorder (ASD) and neurotypically developing (NTD) in terms of balance, postural control, and motor skills. It also examined which motor skills are most affected and whether scores on different assessment tests in ASD children are correlated. A cross-sectional observational study with two research groups was conducted. Timed up and go test (TUG), short form of Bruininks-Oseretsky test of Motor Proficiency version 2 (SFBOT-2), and pediatric balance scale (PBS) were used. A total of 100 participants 50 with ASD and 50 with NTD engaged in the research. Statistically significant differences were obtained between control group and ASD group in TUG test and in SFBOT-2 standard score and total score (p-value = <0.01). A statistically significant difference (p-value = <0.01) was seen between ASD group's and control group's PBS scores. Poor correlation was noted between TUG and SFBOT-2, as well as between PBS and TUG. A moderate correlation was also found between SFBOT-2 and PBS. Children with ASD present difficulties in motor skills and in static and dynamic balance compared to children with NTD. Differences were observed in the motor skills of strength followed by manual dexterity, running speed and agility, fine motor precision, fine motor integration, and balance. The PBS item that showed the greatest difference between the ASD group and control group was maintaining monopodial support with hands on hips. Finally, poor to moderate correlations were obtained between the different tests with statistically significant differences.

本研究探讨了患有自闭症谱系障碍(ASD)的儿童和青少年与神经发育正常(NTD)的儿童和青少年在平衡、姿势控制和运动技能方面的差异。研究还探讨了哪些运动技能最受影响,以及自闭症谱系障碍儿童在不同评估测试中的得分是否相关。该研究由两个研究小组进行横断面观察研究。研究使用了定时起立行走测试(TUG)、布鲁因克斯-奥塞瑞斯基运动能力测试简表第2版(SFBOT-2)和小儿平衡量表(PBS)。共有 100 人参与了研究,其中 50 人为 ASD 患者,50 人为 NTD 患者。对照组和 ASD 组在 TUG 测试、SFBOT-2 标准分和总分上存在统计学差异(P 值 = 0.05)。
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引用次数: 0
Three autism subtypes based on single-subject gray matter network revealed by semi-supervised machine learning 通过半监督机器学习揭示基于单个受试者灰质网络的三种自闭症亚型
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-24 DOI: 10.1002/aur.3183
Guomei Xu, Guohong Geng, Ankang Wang, Zhangyong Li, Zhichao Liu, Yanping Liu, Jun Hu, Wei Wang, Xinwei Li

Autism spectrum disorder (ASD) is a heterogeneous, early-onset neurodevelopmental condition characterized by persistent impairments in social interaction and communication. This study aims to delineate ASD subtypes based on individual gray matter brain networks and provide new insights from a graph theory perspective. In this study, we extracted and normalized single-subject gray matter networks and calculated each network's topological properties. The heterogeneity through discriminative analysis (HYDRA) method was utilized to subtype all patients based on network properties. Next, we explored the differences among ASD subtypes in terms of network properties and clinical measures. Our investigation identified three distinct ASD subtypes. In the case–control study, these subtypes exhibited significant differences, particularly in the precentral gyrus, lingual gyrus, and middle frontal gyrus. In the case analysis, significant differences in global and nodal properties were observed between any two subtypes. Clinically, subtype 1 showed lower VIQ and PIQ compared to subtype 3, but exhibited higher scores in ADOS-Communication and ADOS-Total compared to subtype 2. The results highlight the distinct brain network properties and behaviors among different subtypes of male patients with ASD, providing valuable insights into the neural mechanisms underlying ASD heterogeneity.

自闭症谱系障碍(ASD)是一种异质性的早发性神经发育疾病,其特点是社交互动和沟通能力持续受损。本研究旨在根据个体灰质脑网络划分 ASD 亚型,并从图论角度提供新的见解。在这项研究中,我们提取并归一化了单个受试者的灰质网络,并计算了每个网络的拓扑特性。我们利用异质性判别分析(HYDRA)方法,根据网络属性对所有患者进行了分型。接下来,我们探讨了 ASD 亚型在网络属性和临床指标方面的差异。我们的研究发现了三种不同的 ASD 亚型。在病例对照研究中,这些亚型表现出显著差异,尤其是在中央前回、舌回和额叶中回。在病例分析中,任何两个亚型之间在整体和结节特性上都存在明显差异。在临床上,与亚型 3 相比,亚型 1 的 VIQ 和 PIQ 较低,但与亚型 2 相比,亚型 1 在 ADOS-Communication 和 ADOS-Total 中的得分较高。这些结果突显了不同亚型的男性 ASD 患者之间不同的大脑网络特性和行为,为研究 ASD 异质性的神经机制提供了宝贵的见解。
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引用次数: 0
An alpha 5-GABAA receptor positive allosteric modulator attenuates social and cognitive deficits without changing dopamine system hyperactivity in rats exposed to valproic acid in utero 一种α 5-GABAA受体正性异位调节剂可减轻子宫内暴露于丙戊酸的大鼠的社交和认知障碍,但不会改变多巴胺系统的亢进性
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-22 DOI: 10.1002/aur.3178
Adriana Jesus Souza, Ícaro Silva Freitas, Dishary Sharmin, James M. Cook, Francisco S. Guimarães, Felipe V. Gomes

Autism spectrum disorders (ASDs) are characterized by core behavioral symptoms in the domains of sociability, language/communication, and repetitive or stereotyped behaviors. Deficits in the prefrontal and hippocampal excitatory/inhibitory balance due to a functional loss of GABAergic interneurons are proposed to underlie these symptoms. Increasing the postsynaptic effects of GABA with compounds that selectively modulate GABAergic receptors could be a potential target for treating ASD symptoms. In addition, deficits in GABAergic interneurons have been linked to dopamine (DA) system dysregulation, and, despite conflicting evidence, abnormalities in the DA system activity may underly some ASD symptoms. Here, we investigated whether the positive allosteric modulator of α5-containing GABAA receptors (α5-GABAARs) SH-053-2′F-R-CH3 (10 mg/kg) attenuates behavioral abnormalities in rats exposed to valproic acid (VPA) in utero, an established risk factor for autism. We also evaluated if animals exposed to VPA in utero present changes in the ventral tegmental area (VTA) DA system activity using in vivo electrophysiology and if SH-053-2′F-R-CH3 could attenuate these changes. SH-053-2′F-R-CH3 was administered intraperitoneally 30 min before each behavioral test and electrophysiology. In utero VPA exposure caused male and female rats to present increased repetitive behavior (self-grooming) in early adolescence and deficits in social interaction in adulthood. Male, but not female VPA rats, also presented deficits in recognition memory as adults. SH-053-2′F-R-CH3 attenuated the impairments in sociability and cognitive function in male VPA-exposed rats without attenuating the decreased social interaction in females. Adult male and female VPA-exposed rats also showed an increased VTA DA neuron population activity, which was not changed by SH-053-2′F-R-CH3. Despite sex differences, our findings indicate that α5-GABAARs positive allosteric modulators may effectively attenuate some core ASD symptoms.

自闭症谱系障碍(ASD)的特征是在社交能力、语言/沟通、重复或刻板行为等领域出现核心行为症状。GABA 能中间神经元功能缺失导致的前额叶和海马兴奋/抑制平衡失调被认为是这些症状的根源。使用选择性调节 GABA 能受体的化合物来增加 GABA 的突触后效应,可能是治疗 ASD 症状的一个潜在靶点。此外,GABA能中间神经元的缺陷与多巴胺(DA)系统失调有关,尽管证据相互矛盾,但DA系统活动的异常可能是某些ASD症状的基础。在这里,我们研究了含α5的GABAA受体(α5-GABAARs)的正异位调节剂SH-053-2′F-R-CH3(10 mg/kg)是否能减轻子宫内暴露于丙戊酸(VPA)的大鼠的行为异常。我们还使用体内电生理学方法评估了子宫内暴露于 VPA 的动物是否会出现腹侧被盖区 (VTA) DA 系统活动的变化,以及 SH-053-2′F-R-CH3 是否能减轻这些变化。在每次行为测试和电生理测试前30分钟腹腔注射SH-053-2′F-R-CH3。子宫内暴露于VPA会导致雄性和雌性大鼠在青春期早期出现更多的重复行为(自我梳理),并在成年后出现社会交往障碍。雄性 VPA 大鼠(而非雌性 VPA 大鼠)在成年后也会出现识别记忆缺陷。SH-053-2′F-R-CH3可减轻暴露于VPA的雄性大鼠的社交能力和认知功能障碍,但不能减轻雌性大鼠社交互动能力的下降。暴露于 VPA 的成年雄性和雌性大鼠还表现出 VTA DA 神经元群活动的增加,而 SH-053-2′F-R-CH3 并没有改变这种情况。尽管存在性别差异,但我们的研究结果表明,α5-GABAARs正性异位调节剂可有效减轻某些ASD核心症状。
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引用次数: 0
Family history of psychiatric conditions and development of siblings of children with autism 家族精神病史与自闭症儿童兄弟姐妹的发育。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-19 DOI: 10.1002/aur.3175
Giselle Bellia, Joseph Chang, Zeyan Liew, Angelina Vernetti, Suzanne Macari, Kelly Powell, Katarzyna Chawarska

Younger siblings (SIBS) of children with autism exhibit a wide range of clinical and subclinical symptoms including social, cognitive, language, and adaptive functioning delays. Identifying factors linked with this phenotypic heterogeneity is essential for improving understanding of the underlying biology of the heterogenous outcomes and for early identification of the most vulnerable SIBS. Prevalence of neurodevelopmental (NDD) and neuropsychiatric disorders (NPD) is significantly elevated in families of children with autism. It remains unknown, however, if the family history associates with the developmental outcomes among the SIBS. We quantified history of the NDDs and NPDs commonly reported in families of children with autism using a parent interview and assessed autism symptoms, verbal, nonverbal, and adaptive skills in a sample of 229 SIBS. Multiple regression analyses were used to examine links between family history and phenotypic outcomes, whereas controlling for birth year, age, sex, demographics, and parental education. Results suggest that family history of schizophrenia, depression, anxiety, bipolar disorder, and intellectual disability associate robustly with dimensional measures of social affect, verbal and nonverbal IQ, and adaptive functioning in the SIBS. Considering family history of these disorders may improve efforts to predict long-term outcomes in younger siblings of children with autism and inform about familial factors contributing to high phenotypic heterogenetity in this cohort.

自闭症儿童的年幼兄弟姐妹(SIBS)表现出广泛的临床和亚临床症状,包括社交、认知、语言和适应功能延迟。找出与这种表型异质性相关的因素,对于更好地了解异质性结果的生物学基础以及及早识别最易受影响的 SIBS 至关重要。在自闭症儿童家庭中,神经发育障碍(NDD)和神经精神障碍(NPD)的发病率明显升高。然而,家族病史是否与自闭症儿童家庭的发育结果有关,目前仍不得而知。我们通过家长访谈对自闭症儿童家庭中常见的 NDD 和 NPD 病史进行了量化,并对 229 个 SIBS 样本中的自闭症症状、语言、非语言和适应能力进行了评估。在控制出生年份、年龄、性别、人口统计学特征和父母教育程度的前提下,采用多元回归分析来研究家族史与表型结果之间的联系。结果表明,精神分裂症、抑郁症、焦虑症、双相情感障碍和智力障碍的家族病史与 SIBS 的社会情感、言语和非言语智商以及适应功能的维度测量结果密切相关。考虑到这些疾病的家族史可能会改善对自闭症儿童年幼兄弟姐妹的长期结果的预测,并使人们了解导致该群体表型异质性高的家族因素。
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引用次数: 0
Comparison of propofol-esketamine versus propofol-sufentanil for deep sedation and analgesia in children with autism: A randomized double-blind clinical trial 异丙酚-伊斯卡胺与异丙酚-舒芬太尼用于自闭症儿童深度镇静和镇痛的比较:随机双盲临床试验。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-08 DOI: 10.1002/aur.3172
Yanxiang Miao, Minghui Zheng, Qing Li, Lixia Xiong, Jinxiang Feng, Xiaoyu Liu, Guoxiang Fan, Rupesh Chaturvedi, Faming Zhang, Ning Yin

Propofol sedation, routinely used for endoscopic procedures, is safe and acceptable for children. Adjuvants, such as esketamine or sufentanil, are commonly added to improve the efficacy and safety of propofol sedation. This study aimed to compare the clinical efficacy and safety of propofol-esketamine (PE) versus propofol-sufentanil (PS) for deep sedation and analgesia in children with autism undergoing colonoscopy procedure. One hundred and twenty-four children with autism undergoing colonoscopy procedure were included in the study. Patients were randomly assigned to receive one of the two adjuvants: esketamine (0.3 mg/kg) or sufentanil (0.2 μg/kg), subsequently administered propofol 2.0 mg/kg to induce anesthesia. Additional doses of propofol (0.5–1.0 mg/kg) were administered as needed to ensure patient tolerance for the remaining duration of the procedure. Movement during the procedure, hemodynamic variables, the total dose of propofol, recovery time, and adverse events were recorded. The PE group exhibited a significantly lower incidence of severe movement during the procedure compared with the PS group (14.52% vs. 32.26%, p = 0.020). The PE group showed significantly lower incidence of respiratory depression, hypotension, and severe injection pain of propofol than the PS group during the procedure (all p < 0.05). The mean arterial pressure (MAP) decreased significantly after anesthesia induction in the PS group and remained lower than baseline (all p < 0.05). Compared with the combination of low-dose sufentanil (0.2 μg/mg) with propofol, the low-dose esketamine (0.3 mg/kg) combined with propofol provided more stable hemodynamics, higher quality of sedation, and fewer adverse events in children with autism undergoing colonoscopy procedure.

异丙酚镇静是内窥镜手术的常规用药,对儿童安全且可接受。为了提高异丙酚镇静的疗效和安全性,通常会添加艾司卡胺或舒芬太尼等辅助剂。本研究旨在比较异丙酚-依司卡胺(PE)与异丙酚-舒芬太尼(PS)对接受结肠镜检查的自闭症儿童进行深度镇静和镇痛的临床疗效和安全性。研究共纳入了124名接受结肠镜检查的自闭症儿童。患者被随机分配到两种辅助剂中的一种:艾司卡胺(0.3 毫克/千克)或舒芬太尼(0.2 微克/千克),随后使用异丙酚 2.0 毫克/千克诱导麻醉。在剩余的手术时间内,根据需要追加异丙酚剂量(0.5-1.0 毫克/千克),以确保患者的耐受性。手术过程中的运动、血液动力学变量、异丙酚的总剂量、恢复时间和不良事件均被记录在案。与 PS 组相比,PE 组在手术过程中发生严重移动的比例明显较低(14.52% 对 32.26%,P = 0.020)。在手术过程中,PE 组出现呼吸抑制、低血压和异丙酚注射剧痛的几率明显低于 PS 组(所有 p
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引用次数: 0
Hyper-focus, sticky attention, and springy attention in young autistic children: Associations with sensory behaviors and cognitive ability 年幼自闭症儿童的过度专注、粘性注意力和弹簧式注意力:与感官行为和认知能力的关联。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-05 DOI: 10.1002/aur.3174
Patrick Dwyer, Andre Sillas, Melanie Prieto, Emily Camp, Christine Wu Nordahl, Susan M. Rivera

The autistic-developed monotropism account suggests that atypical, domain-general attentional hyper-focus on interests is a central aspect of autism, but domain-general attention differences in autism can manifest differently. Prior research suggests autistic children are often slow to disengage attention from stimuli—a pattern often called “sticky attention”—and that they can show reduced novelty preference. These attentional patterns could influence sensory experiences and learning. We used eye-tracking to investigate novelty preference and “sticky attention” in young autistic children; we also examined whether attentional patterns were related to cognitive abilities and caregiver-reported sensory responsiveness. A total of 46 autistic and 28 nonautistic participants, aged between 2 and 4 years, provided usable data. We found no evidence that autistic children exhibited greater “sticky attention” than nonautistics, but “sticky attention” in autism was associated with more caregiver-reported sensory hyper-responsiveness, seeking/interests, and enhanced perception. Autistic children also nonsignificantly trended toward exhibiting reduced novelty preference. Unexpectedly, the time-course of this trending novelty preference difference implied it was not driven by reduced orienting to novelty, but increased returning to already-familiarized stimuli: what we call “springy attention.” Exploratory analyses of data from the attentional disengagement task suggest autistic participants may have exhibited greater “springy attention,” though further research with paradigms optimized for measuring this construct should confirm this. Importantly, “springy attention” was robustly related to reduced cognitive abilities and greater caregiver-reported hypo-responsiveness. Thus, this study illuminates two distinct domain-general attentional patterns, each with distinct correlates in young autistic children, which could have important implications for understanding autistic children's learning, development, and experiences.

自闭症形成的单向性观点认为,对兴趣的非典型、领域性注意力过度集中是自闭症的一个核心方面,但自闭症儿童的领域性注意力差异会有不同表现。先前的研究表明,自闭症儿童从刺激中脱离注意力的速度通常较慢--这种模式通常被称为 "粘性注意力"--而且他们会表现出较低的新奇偏好。这些注意模式可能会影响感官体验和学习。我们利用眼动追踪技术研究了自闭症幼儿的新奇偏好和 "粘性注意";我们还研究了注意模式是否与认知能力和照顾者报告的感官反应能力有关。共有 46 名自闭症儿童和 28 名非自闭症儿童提供了可用数据,他们的年龄在 2 到 4 岁之间。我们没有发现证据表明自闭症儿童比非自闭症儿童表现出更强的 "粘性注意",但自闭症儿童的 "粘性注意 "与护理人员报告的更多感官过度反应、寻求/兴趣和感知增强有关。自闭症儿童对新奇事物的偏好也呈下降趋势,但并不显著。意想不到的是,这种新奇偏好差异趋势的时间进程表明,其驱动因素不是对新奇的定向减少,而是对已经熟悉的刺激的回归增加:我们称之为 "弹簧式注意"。对注意力脱离任务数据的探索性分析表明,自闭症参与者可能表现出了更强的 "弹簧式注意力",不过,对这一结构进行优化的范式的进一步研究应能证实这一点。重要的是,"跳跃性注意力 "与认知能力下降和护理人员报告的反应迟钝密切相关。因此,本研究揭示了自闭症幼儿的两种不同的领域一般注意模式,每种模式都有不同的相关性,这可能对理解自闭症儿童的学习、发展和经历有重要影响。
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引用次数: 0
Impaired inhibitory control when processing real but not cartoon emotional faces in autistic children: Evidence from an event-related potential study 自闭症儿童在处理真实而非卡通情绪面孔时的抑制控制能力受损:来自事件相关电位研究的证据。
IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Pub Date : 2024-06-05 DOI: 10.1002/aur.3176
Hyun Kyung Lee, Shelley Xiuli Tong

Impaired socioemotional functioning characterizes autistic children, but does weak inhibition control underlie their socioemotional difficulty? This study addressed this question by examining whether and, if so, how inhibition control is affected by face realism and emotional valence in school-age autistic and neurotypical children. Fifty-two autistic and 52 age-matched neurotypical controls aged 10–12 years completed real and cartoon emotional face Go/Nogo tasks while event-related potentials (ERPs) were recorded. The analyses of inhibition–emotion components (i.e., N2, P3, and LPP) and a face-specific N170 revealed that autistic children elicited greater N2 while inhibiting Nogo trials and greater P3/LPP and late LPP for real but not cartoon emotional faces. Moreover, autistic children exhibited a reduced N170 to real face emotions only. Furthermore, correlation results showed that better behavioral inhibition and emotion recognition in autistic children were associated with a reduced N170. These findings suggest that neural mechanisms of inhibitory control in autistic children are less efficient and more disrupted during real face processing, which may affect their age-appropriate socio-emotional development.

社会情感功能受损是自闭症儿童的特点,但抑制控制能力弱是否是他们社会情感障碍的根源?本研究针对这一问题,研究了学龄自闭症儿童和神经畸形儿童的抑制控制能力是否会受到面部真实性和情绪情感的影响,以及如果会受到影响,抑制控制能力会如何受到面部真实性和情绪情感的影响。52 名年龄在 10-12 岁的自闭症儿童和 52 名年龄匹配的神经症对照组儿童在完成真实和卡通情绪面孔 Go/Nogo 任务的同时记录了事件相关电位(ERPs)。对抑制-情绪成分(即 N2、P3 和 LPP)以及脸部特异性 N170 的分析表明,自闭症儿童在抑制 Nogo 试验时会产生更强的 N2,而对真实情绪脸部(而非卡通情绪脸部)会产生更强的 P3/LPP 和晚期 LPP。此外,自闭症儿童仅对真实面孔情绪表现出较低的 N170。此外,相关结果表明,自闭症儿童较好的行为抑制和情绪识别能力与 N170 的降低有关。这些研究结果表明,自闭症儿童的抑制控制神经机制在真实面孔处理过程中效率较低,受到的干扰较多,这可能会影响他们与年龄相适应的社会情感发展。
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引用次数: 0
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Autism Research
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