Journal of Neurodevelopmental Disorders最新文献

Background: Emotion regulation (ER) difficulties are common in autistic individuals and may contribute to co-occurring psychopathology during adolescence. However, age-group heterogeneity in existing research limits understanding of ER processes in autistic adolescents. Therefore, this mixed methods systematic review synthesizes current knowledge on ER in autistic adolescents aged 10-24 years.

Methods: We systematically searched MEDLINE, PsycINFO, Web of Science, and Scopus for empirical studies on ER in autistic adolescents. 32 studies (including two qualitative) met inclusion criteria and were synthesized using a convergent integrated approach.

Results: Autistic adolescents consistently exhibited more ER difficulties than non-autistic peers, which were associated with internalizing and externalizing symptoms. Greater autism symptom severity, lower theory of mind, and social challenges were frequently linked to lower ER, while no consistent associations with age, gender, or IQ were found. Few studies examined physiological or neurobiological factors, but evidence suggested associations between ER difficulties, lower heart rate variability, and atypical neural responses. Cognitive-behavioral and mindfulness-based interventions generally led to improvements in ER, though results varied and discrepancies between self- and proxy-reports were common.

Conclusion: ER challenges are pronounced in autistic adolescents and are closely associated with mental health symptoms. While interventions show promise, future research should address measurement heterogeneity, examine neurobiological underpinnings, and include more longitudinal and ecologically valid designs.

Trial registration: CRD42024529184 (registered April 06, 2024).

Eye contact is one of the most important forms of interpersonal communication. Nonetheless, research has shown that there is no gold standard for how eye contact should occur. Atypicalities in eye contact are one of the core features of autism spectrum disorder (ASD), but there is still no consensus on what constitutes atypical eye contact in ASD. The current research explores both the breadth and depth of experiences with eye contact in adults with and without ASD. We used a hermeneutic phenomenological multicenter design in which 15 adults with ASD and 15 adults without ASD were interviewed. Analyses using Multisite Qualitative Analysis (MSQA) and the PRICE model for saturation identified four themes: opinion on eye contact, experience of eye contact, approach toward eye contact, and needs regarding eye contact. Adults with and without ASD appeared to have overlapping and distinct experiences. This study provides the first insights into similarities and differences in experiences with eye contact in adults with and without ASD. The results provide guidance for future research and for the development of interventions to reduce problems arising from eye contact in ASD.

Background: Importance: The neurodevelopmental outcomes of children born after medically assisted reproduction remain incompletely characterized on a population level. We were to assess the incidence and relative risk of neurodevelopmental delay in the children of infertile women born after unassisted conception, intrauterine insemination (IUI), and in vitro fertilization (IVF).

Method: We conducted a retrospective cohort study using the National Health Insurance Service database of South Korea from October 2017 through December 2023. The study included 115 839 singleton, full-term, non-low-birthweight children born to women aged 20-49 years with a diagnosis of female infertility. The exposure was mode of conception-spontaneous, IUI, or IVF-balanced by propensity score matching on preconceptional maternal factors. Outcome measure was neurodevelopmental delay, defined as scoring below the cutoff in any of six functional domains on the Korean Developmental Screening Test across six consecutive rounds. Crude incidence rate ratios (IRRs) and adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models.

Results: Among 115 839 children, 6 575 (5.7%) exhibited delay in at least one domain. Crude IRRs for any delay were 1.19 (95% confidence interval [CI]: 1.07, 1.61) for IUI and 1.10 (95% CI: 1.03, 1.17) for IVF versus unassisted conception. In the survival models, higher risks persisted for both IUI (aHR = 1.19; 95% CI: 1.06, 1.34) and IVF (1.09, 95% CI: 1.02, 1.06) compared with unassisted conception. When comparing IVF and IUI, IVF conferred a lower risk of fine motor delay than IUI (0.84, 95% CI: 0.72, 0.99). Among IVF births, risk of developmental delay was similar across all six domains for frozen and fresh embryo transfers.

Conclusions: Children conceived via IUI or IVF demonstrated a modest but significant increase in screen-positive neurodevelopmental delay compared with those conceived spontaneously. These findings highlight the need for neurodevelopmental monitoring in this population.

Background: Dysregulated endocannabinoid signaling is involved in Fragile X syndrome (FXS), suggesting a potential role for the endocannabinoid signaling modulator, cannabidiol, in treatment. ZYN002 is a synthetic cannabidiol that has been uniquely formulated as a gel for transdermal delivery and is currently under investigation for the treatment of behavioral symptoms associated with FXS.

Design: ZYN2-CL-017 is an ongoing, long-term, open-label extension (OLE) safety trial of ZYN002 in patients with FXS. We are enrolling patients from past and current ZYN002 clinical trials to evaluate the safety and tolerability of ZYN002 in patients with FXS.

Methods: Primary safety assessments were conducted in patients who enrolled into the OLE from 2 completed ZYN002 trials. Secondary analyses, conducted in a subgroup enrolled from a completed placebo-controlled trial of ZYN002, included the FXS-specific Aberrant Behavior Checklist-Community Social Avoidance and Irritability subscales (ABC-C_FXS SA and ABC-C_FXS Irr, examined change from baseline of the randomized study) and the Caregiver Global Impression of Change (CaGI-C, examined change from baseline of the OLE), in which caregivers were asked to rate the change in their child's overall behavior.

Results: At the time of this interim analysis data cut (January 31, 2024), 240 patients had been enrolled from 2 completed ZYN002 trials. Mean age at entry to the OLE was 9.7 years (range 3-17 years), and the majority were male (76.3%) and White (80.4%). Mean exposure to ZYN002 during the initial trials and OLE was 28 months. Treatment-related adverse events (AEs) were reported in 12.9% of patients; the most common (6.7% of patients) was short-term application site pain. The highest degree of skin irritation reported by investigators was moderate erythema in 7 patients (2.9%). In the secondary analysis cohort (n=196 evaluable patients), patients demonstrated clinically meaningful changes in ABC-C_FXS SA, ABC-C_FXS Irr, and CaGI-C scores.

Conclusions: Interim analysis results of the ongoing OLE in children, adolescents, and young adults with FXS demonstrated that ZYN002 has a favorable long-term safety profile and is generally well tolerated. Clinically meaningful changes in behaviors from baseline continued to be observed during the OLE. These findings support further study of ZYN002 in patients with FXS.

Trial registration: ZYN2-CL-017 is registered on Clinicaltrials.gov (NCT03802799) on December 26, 2018.

Background: CLN3 disease, also known as juvenile Batten disease, is a recessively inherited neurodevelopmental disorder caused by mutations in the CLN3 gene. It represents the most common form of Neuronal Ceroid Lipofuscinoses (NCLs), a group of lysosomal storage disorders that impair brain function. Clinical features include progressive vision loss, language impairment, and cognitive decline. The early onset of visual deficits complicates the neurological assessment of cognitive dysfunction, while the rarity of CLN3 cases limits the study of sex-specific disease trajectories in humans. Therefore, there is a critical need for objective, translational biomarkers to monitor disease progression and support therapeutic development in preclinical animal models.

Methods: Building on our recent studies in individuals with CLN3 disease, we developed a parallel experimental paradigm using high-density electroencephalography (EEG) in Cln3 knockout (Cln3-/-) mice to longitudinally assess auditory neurophysiological changes. We applied a duration-based mismatch negativity (MMN) paradigm, similar to that used in our human studies, to evaluate automatic detection of auditory pattern changes in male and female mice between 3 and 9 months of age.

Results: Wild-type (WT) mice of both sexes showed robust and stable duration MMN responses across this age range. In contrast, Cln3-/- mice showed marked sex- and age-dependent deficits: female mutants displayed persistent MMN deficits, whereas male mutants exhibited early MMN abnormalities that unexpectedly improved with age. Auditory brainstem responses confirmed intact peripheral hearing in Cln3-/- mice, indicating a central origin for the observed abnormalities. Further analyses revealed that MMN impairments were driven by age- and sex-specific alterations in auditory evoked potentials to both standard and deviant stimuli.

Conclusions: These findings demonstrate sex- and age-dependent disruptions in central auditory processing in Cln3-/- mice and support auditory duration MMN as a sensitive, translational biomarker of brain dysfunction in CLN3 disease. This approach offers a functional, cross-species measure for tracking disease progression and evaluating therapeutic interventions in Batten disease.

This comprehensive review aimed to investigate the transferability of transcranial electrical Stimulation (tES) interventions in individuals with specific learning disabilities (SLD) based on the FIELD model, encompassing function, implements, ecology, level, and durability. A systematic search of electronic databases yielded a total of 13 eligible studies, 11 transcranial direct current stimulation (tDCS), 1 transcranial random noise stimulation (tRNS), and 1 transcranial alternating current stimulation (tACS), encompass 286 individuals with SLD, for inclusion. The overall effect size analysis revealed positive transfer effects in all domains of FIELD, indicating the potential effectiveness of non-invasive brain stimulations (NIBS) interventions in enhancing various aspects of learning and behavior in individuals with SLD. The subgroup analysis further underscored the positive impact of age, dose, and concurrent intervention on transferability. In conclusion, this study contributes valuable insights into the transferability of tES interventions and holds promise for improving learning and behavioral outcomes in individuals with SLD.

Background: The Angelman Syndrome Video Assessment (ASVA) is a clinician-reported outcome measure that was developed to assess the functional ability of individuals with Angelman Syndrome (AS) in a familiar environment. Through standardized tasks and associated scorecards, clinicians assess four meaningful domains of functioning: communication, activities of daily living (ADLs, which include fine motor skills), gross motor, and external direction (i.e., the ability to follow directions) via scorecards with pre-established criteria. The aim of this project was to develop and refine the scorecards using a rigorous process in partnership with caregivers, clinicians, and researchers in the AS community.

Methods: The Scorecard development process included four phases: (1) video source material study, (2) identification of initial scoring criteria, (3) scorecard drafts, and (4) two (Caregiver and Clinician panel and PT panel) two-round modified Delphi processes to reach consensus. All phases were conducted remotely except for Round 2 of the Caregiver and Clinician Delphi Panel, which was conducted in person. Votes were held for each scoring criterion and consensus was defined as ≥ 70% agreement.

Results: In the communication, ADLs, and external direction domains, scorecard criteria reached 80 to 100% agreement among caregivers (n = 8) and clinicians (n = 2), resulting in a total of 218 scoring criteria and levels across 10 tasks. In the gross motor domain, scorecard criteria reached 100% agreement among physical therapists (n = 8) with a total of 347 scoring criteria and levels across 8 tasks.

Conclusions: The ASVA was developed with insights from the AS community, including caregivers of individuals with AS, clinicians, and researchers. The ASVA is a novel, disease-specific, clinician-reported outcome measure that uses standardized video capture and scorecards that were developed through a rigorous process, resulting in well-developed criteria to quantify meaningful changes of function in individuals with AS in communication, ADLs, gross motor function, and external direction.