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Sex differences during development in cortical temporal processing and event related potentials in wild-type and fragile X syndrome model mice. 野生型和脆性 X 综合征模型小鼠大脑皮层时间处理和事件相关电位发育过程中的性别差异。
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-08 DOI: 10.1186/s11689-024-09539-8
Katilynne Croom, Jeffrey A Rumschlag, Michael A Erickson, Devin Binder, Khaleel A Razak

Background: Autism spectrum disorder (ASD) is currently diagnosed in approximately 1 in 44 children in the United States, based on a wide array of symptoms, including sensory dysfunction and abnormal language development. Boys are diagnosed ~ 3.8 times more frequently than girls. Auditory temporal processing is crucial for speech recognition and language development. Abnormal development of temporal processing may account for ASD language impairments. Sex differences in the development of temporal processing may underlie the differences in language outcomes in male and female children with ASD. To understand mechanisms of potential sex differences in temporal processing requires a preclinical model. However, there are no studies that have addressed sex differences in temporal processing across development in any animal model of ASD.

Methods: To fill this major gap, we compared the development of auditory temporal processing in male and female wildtype (WT) and Fmr1 knock-out (KO) mice, a model of Fragile X Syndrome (FXS), a leading genetic cause of ASD-associated behaviors. Using epidural screw electrodes, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (ASSR) paradigm at young (postnatal (p)21 and p30) and adult (p60) ages from both auditory and frontal cortices of awake, freely moving mice.

Results: The results show that ERP amplitudes were enhanced in both sexes of Fmr1 KO mice across development compared to WT counterparts, with greater enhancement in adult female than adult male KO mice. Gap-ASSR deficits were seen in the frontal, but not auditory, cortex in early development (p21) in female KO mice. Unlike male KO mice, female KO mice show WT-like temporal processing at p30. There were no temporal processing deficits in the adult mice of both sexes.

Conclusions: These results show a sex difference in the developmental trajectories of temporal processing and hypersensitive responses in Fmr1 KO mice. Male KO mice show slower maturation of temporal processing than females. Female KO mice show stronger hypersensitive responses than males later in development. The differences in maturation rates of temporal processing and hypersensitive responses during various critical periods of development may lead to sex differences in language function, arousal and anxiety in FXS.

背景:目前,美国每 44 名儿童中就有 1 名被诊断患有自闭症谱系障碍 (ASD),其症状多种多样,包括感官功能障碍和语言发育异常。男孩被诊断为自闭症的频率是女孩的 3.8 倍。听觉颞区处理对语言识别和语言发展至关重要。颞叶处理发育异常可能是导致 ASD 语言障碍的原因。颞叶处理发育过程中的性别差异可能是患有 ASD 的男女儿童在语言成果方面存在差异的原因。要了解时间处理过程中潜在的性别差异机制,需要一个临床前模型。然而,目前还没有任何研究涉及 ASD 动物模型在整个发育过程中时间处理的性别差异:为了填补这一重大空白,我们比较了雄性和雌性野生型(WT)小鼠和 Fmr1 基因敲除(KO)小鼠的听觉时间处理发育情况,后者是脆性 X 综合征(FXS)的模型,而脆性 X 综合征是 ASD 相关行为的主要遗传原因。我们使用硬膜外螺钉电极,通过噪声间隙听觉稳态反应(ASSR)范式,记录了清醒、自由活动的小鼠在幼年(出生后(p)21 和 p30)和成年(p60)时的听觉和额叶皮层的听觉事件相关电位(ERP)和听觉时间处理过程:结果表明,与 WT 小鼠相比,Fmr1 KO 小鼠的ERP 振幅在整个发育过程中都有所增强,其中成年雌性 KO 小鼠比成年雄性 KO 小鼠的增强幅度更大。在雌性KO小鼠的早期发育阶段(p21),额叶皮层(而非听觉皮层)出现了间隙-ASSR缺陷。与雄性 KO 小鼠不同,雌性 KO 小鼠在 p30 阶段表现出与 WT 小鼠类似的颞叶处理能力。成年雌雄小鼠均无颞叶处理缺陷:这些结果表明,Fmr1 KO 小鼠的时间处理和超敏反应的发育轨迹存在性别差异。雄性 KO 小鼠的时间处理成熟比雌性慢。雌性 KO 小鼠在发育后期比雄性表现出更强的超敏反应。在发育的各个关键时期,时间处理和超敏反应的成熟速度存在差异,这可能会导致FXS患者在语言功能、唤醒和焦虑方面存在性别差异。
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引用次数: 0
Reduced lateralization of multiple functional brain networks in autistic males. 自闭症男性大脑多个功能网络的侧化减少
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-08 DOI: 10.1186/s11689-024-09529-w
Madeline Peterson, Molly B D Prigge, Dorothea L Floris, Erin D Bigler, Brandon A Zielinski, Jace B King, Nicholas Lange, Andrew L Alexander, Janet E Lainhart, Jared A Nielsen

Background: Autism spectrum disorder has been linked to a variety of organizational and developmental deviations in the brain. One such organizational difference involves hemispheric lateralization, which may be localized to language-relevant regions of the brain or distributed more broadly.

Methods: In the present study, we estimated brain hemispheric lateralization in autism based on each participant's unique functional neuroanatomy rather than relying on group-averaged data. Additionally, we explored potential relationships between the lateralization of the language network and behavioral phenotypes including verbal ability, language delay, and autism symptom severity. We hypothesized that differences in hemispheric asymmetries in autism would be limited to the language network, with the alternative hypothesis of pervasive differences in lateralization. We tested this and other hypotheses by employing a cross-sectional dataset of 118 individuals (48 autistic, 70 neurotypical). Using resting-state fMRI, we generated individual network parcellations and estimated network asymmetries using a surface area-based approach. A series of multiple regressions were then used to compare network asymmetries for eight significantly lateralized networks between groups.

Results: We found significant group differences in lateralization for the left-lateralized Language (d = -0.89), right-lateralized Salience/Ventral Attention-A (d = 0.55), and right-lateralized Control-B (d = 0.51) networks, with the direction of these group differences indicating less asymmetry in autistic males. These differences were robust across different datasets from the same participants. Furthermore, we found that language delay stratified language lateralization, with the greatest group differences in language lateralization occurring between autistic males with language delay and neurotypical individuals.

Conclusions: These findings evidence a complex pattern of functional lateralization differences in autism, extending beyond the Language network to the Salience/Ventral Attention-A and Control-B networks, yet not encompassing all networks, indicating a selective divergence rather than a pervasive one. Moreover, we observed an association between Language network lateralization and language delay in autistic males.

背景:自闭症谱系障碍与大脑的各种组织和发育偏差有关。其中一种组织差异涉及大脑半球侧化,这种侧化可能局限于大脑中与语言相关的区域,也可能分布更广:在本研究中,我们根据每位受试者独特的功能神经解剖学而非群体平均数据来估计自闭症患者的大脑半球侧化。此外,我们还探讨了语言网络侧向化与行为表型(包括言语能力、语言延迟和自闭症症状严重程度)之间的潜在关系。我们假设自闭症患者大脑半球不对称的差异仅限于语言网络,而另一种假设是侧化差异普遍存在。我们利用 118 名患者(48 名自闭症患者,70 名神经畸形患者)的横断面数据集测试了这一假设和其他假设。通过静息态 fMRI,我们生成了个体网络细分,并使用基于表面积的方法估计了网络的不对称性。然后,我们使用一系列多元回归来比较八个显著侧化网络的组间网络不对称性:结果:我们发现,左侧化的语言网络(d = -0.89)、右侧化的 "注意力/中枢注意-A "网络(d = 0.55)和右侧化的 "控制-B "网络(d = 0.51)在侧向化方面存在明显的群体差异。这些差异在来自同一参与者的不同数据集中是稳健的。此外,我们还发现语言延迟使语言侧化分层,语言侧化的最大群体差异出现在患有语言延迟的男性自闭症患者和神经畸形患者之间:这些研究结果表明,自闭症患者的功能侧化差异模式非常复杂,从语言网络延伸到 "显著性"/"中枢注意"-A 和 "控制"-B 网络,但并不包括所有网络,这表明自闭症患者的功能侧化差异是选择性的,而不是普遍性的。此外,我们还观察到自闭症男性的语言网络侧化与语言延迟之间存在关联。
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引用次数: 0
Behavioral changes in patients with Prader-Willi syndrome receiving diazoxide choline extended-release tablets compared to the PATH for PWS natural history study 与 PATH for PWS 自然史研究相比,接受二氮唑胆碱缓释片治疗的普拉德-威利综合征患者的行为变化
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-26 DOI: 10.1186/s11689-024-09536-x
Theresa V. Strong, Jennifer L. Miller, Shawn E. McCandless, Evelien Gevers, Jack A. Yanovski, Lisa Matesevac, Jessica Bohonowych, Shaila Ballal, Kristen Yen, Patricia Hirano, Neil M. Cowen, Anish Bhatnagar
Prader-Willi syndrome (PWS) is a rare neurobehavioral-metabolic disease caused by the lack of paternally expressed genes in the chromosome 15q11-q13 region, characterized by hypotonia, neurocognitive problems, behavioral difficulties, endocrinopathies, and hyperphagia resulting in severe obesity if energy intake is not controlled. Diazoxide choline extended-release (DCCR) tablets have previously been evaluated for their effects on hyperphagia and other behavioral complications of people with PWS in a Phase 3 placebo-controlled study of participants with PWS, age 4 and older with hyperphagia (C601) and in an open label extension study, C602. To better understand the longer-term impact of DCCR, a cohort from PATH for PWS, a natural history study that enrolled participants with PWS age 5 and older, who met the C601 age, weight and baseline hyperphagia inclusion criteria and had 2 hyperphagia assessments ≥ 6 months apart, were compared to the C601/C602 cohort. Hyperphagia was measured using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT, range 0–36). The primary analysis used observed values with no explicit imputation of missing data. A sensitivity analysis was conducted in which all missing HQ-CT assessments in the C601/C602 cohort were assigned the highest possible value (36), representing the worst-case scenario. Other behavioral changes were assessed using the Prader-Willi Syndrome Profile questionnaire (PWSP). Relative to the PATH for PWS natural history study cohort, the DCCR-treated C601/C602 cohort showed significant improvements in HQ-CT score at 26 weeks (LSmean [SE] -8.3 [0.75] vs. -2.5 [0.43], p < 0.001) and 52 weeks (LSmean [SE] -9.2 [0.77] vs. -3.4 [0.47], p < 0.001). The comparison between the cohorts remained significant in the worst-case imputation sensitivity analysis. There were also significant improvements in all domains of the PWSP at 26 weeks (all p < 0.001) and 52 weeks (all p ≤ 0.003) for C601/C602 participants compared to the PATH for PWS participants. Long-term administration of DCCR to people with PWS resulted in changes in hyperphagia and other behavioral complications of PWS that are distinct from the natural history of the syndrome as exemplified by the cohort from PATH for PWS. The combined effects of administration of DCCR should reduce the burden of the syndrome on the patient, caregivers and their families, and thereby may benefit people with PWS and their families. Clinical study C601 was originally registered on ClinicalTrials.gov on February 22, 2018 (NCT03440814). Clinical study C602 was originally registered on ClinicalTrials.gov on October 22, 2018 (NCT03714373). PATH for PWS was originally registered on ClinicalTrials.gov on October 24, 2018 (NCT03718416).
普拉德-威利综合征(Prader-Willi Syndrome,PWS)是一种罕见的神经行为代谢疾病,由染色体 15q11-q13 区域缺乏父系表达基因引起,其特征是肌张力低下、神经认知问题、行为障碍、内分泌病变以及多食,如果不控制能量摄入,会导致严重肥胖。重氮胆碱缓释片(DCCR)曾在一项针对 4 岁及以上患有多食症的 PWS 患者的 3 期安慰剂对照研究(C601)和一项开放标签扩展研究(C602)中评估了其对 PWS 患者多食症和其他行为并发症的影响。为了更好地了解 DCCR 的长期影响,我们将 PATH for PWS 的一组患者与 C601/C602 的患者进行了比较,PATH for PWS 是一项自然史研究,招募了 5 岁及以上的 PWS 患者,这些患者符合 C601 的年龄、体重和基线多食症纳入标准,并且两次多食症评估相隔时间≥ 6 个月。多食症使用临床试验多食症问卷(HQ-CT,范围 0-36)进行测量。主要分析采用观察值,未对缺失数据进行明确估算。在敏感性分析中,C601/C602队列中所有缺失的HQ-CT评估值都被赋予了可能的最高值(36),这代表了最坏的情况。其他行为变化采用普拉德-威利综合征档案问卷(PWSP)进行评估。与 PATH for PWS 自然史研究队列相比,DCCR 治疗的 C601/C602 队列在 26 周(LSmean [SE] -8.3 [0.75] vs. -2.5 [0.43],p < 0.001)和 52 周(LSmean [SE] -9.2 [0.77] vs. -3.4 [0.47],p < 0.001)的 HQ-CT 评分有显著改善。在最坏情况估算敏感性分析中,各组间的比较仍然显著。与PWS参与者的PATH相比,C601/C602参与者在26周(所有P<0.001)和52周(所有P≤0.003)的PWSP所有领域都有明显改善。对PWS患者长期服用DCCR会导致吞咽功能亢进和PWS的其他行为并发症发生变化,这与PATH治疗PWS队列中的综合征自然病史不同。服用 DCCR 的综合效果应能减轻该综合征给患者、护理人员及其家人带来的负担,从而使 PWS 患者及其家人受益。临床研究C601最初于2018年2月22日在ClinicalTrials.gov上注册(NCT03440814)。临床研究C602最初于2018年10月22日在ClinicalTrials.gov上注册(NCT03714373)。PATH治疗PWS最初于2018年10月24日在ClinicalTrials.gov上注册(NCT03718416)。
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引用次数: 0
An overview of current advances in perinatal alcohol exposure and pathogenesis of fetal alcohol spectrum disorders 围产期酒精暴露和胎儿酒精谱系障碍发病机制的最新进展概述
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-20 DOI: 10.1186/s11689-024-09537-w
Xingdong Zeng, Yongle Cai, Mengyan Wu, Haonan Chen, Miao Sun, Hao Yang
The adverse use of alcohol is a serious global public health problem. Maternal alcohol consumption during pregnancy usually causes prenatal alcohol exposure (PAE) in the developing fetus, leading to a spectrum of disorders known as fetal alcohol spectrum disorders (FASD) and even fetal alcohol syndrome (FAS) throughout the lifelong sufferers. The prevalence of FASD is approximately 7.7 per 1,000 worldwide, and is even higher in developed regions. Generally, Ethanol in alcoholic beverages can impair embryonic neurological development through multiple pathways leading to FASD. Among them, the leading mechanism of FASDs is attributed to ethanol-induced neuroinflammatory damage to the central nervous system (CNS). Although the underlying molecular mechanisms remain unclear, the remaining multiple pathological mechanisms is likely due to the neurotoxic damage of ethanol and the resultant neuronal loss. Regardless of the molecular pathway, the ultimate outcome of the developing CNS exposed to ethanol is almost always the destruction and apoptosis of neurons, which leads to the reduction of neurons and further the development of FASD. In this review, we systematically summarize the current research progress on the pathogenesis of FASD, which hopefully provides new insights into differential early diagnosis, treatment and prevention for patents with FASD.
酗酒是一个严重的全球性公共卫生问题。母亲在怀孕期间饮酒通常会导致发育中的胎儿出现产前酒精暴露(PAE),从而导致一系列疾病,即胎儿酒精谱系障碍(FASD),甚至导致胎儿酒精综合症(FAS),患者终生受其折磨。全世界 FASD 的发病率约为 7.7‰,发达地区的发病率更高。一般来说,酒精饮料中的乙醇会通过多种途径损害胚胎神经系统的发育,从而导致 FASD。其中,导致 FASD 的主要机制是乙醇引起的中枢神经系统(CNS)神经炎症损伤。尽管潜在的分子机制尚不清楚,但其余的多种病理机制很可能是由于乙醇的神经毒性损伤以及由此导致的神经元损失。无论分子途径如何,暴露于乙醇的发育中中枢神经系统的最终结果几乎总是神经元的破坏和凋亡,从而导致神经元的减少,并进一步发展为 FASD。在这篇综述中,我们系统地总结了目前有关 FASD 发病机制的研究进展,希望能为 FASD 患者的早期鉴别诊断、治疗和预防提供新的思路。
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引用次数: 0
Neurobehavioral outcomes of neonatal asymptomatic congenital cytomegalovirus infection at 12-months 新生儿无症状先天性巨细胞病毒感染 12 个月后的神经行为结果
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-18 DOI: 10.1186/s11689-024-09533-0
Sally M. Stoyell, Jed T. Elison, Emily Graupmann, Neely C. Miller, Jessica Emerick, Elizabeth Ramey, Kristen Sandness, Mark R. Schleiss, Erin A. Osterholm
Congenital cytomegalovirus (cCMV) is the most common congenital viral infection in the United States. Symptomatic infections can cause severe hearing loss and neurological disability, although ~ 90% of cCMV infections are asymptomatic at birth. Despite its prevalence, the long-term neurobehavioral risks of asymptomatic cCMV infections are not fully understood. The objective of this work was to evaluate for potential long-term neurobehavioral sequelae in infants with asymptomatic cCMV. Infants with cCMV were identified from a universal newborn cCMV screening study in a metropolitan area in the midwestern United States. Asymptomatic infants with cCMV were enrolled in a longitudinal neurodevelopmental study (N = 29). Age- and sex-matched healthy control infants (N = 193) were identified from the Baby Connectome Project (BCP), a longitudinal study of brain and behavioral development. The BCP sample supplemented an additional group of healthy control infants (N = 30), recruited from the same participant registry as the BCP specifically for comparison with infants with asymptomatic cCMV. Neurobehavioral assessments and parent questionnaires, including the Mullen Scales of Early Learning, the Repetitive Behavior Scales for Early Childhood (RBS-EC), and the Infant Toddler Social Emotional Assessment (ITSEA) were administered at 12 months of age. Neurobehavioral scores were compared between infants with asymptomatic cCMV and all identified healthy control infants. Infants with asymptomatic cCMV performed equivalently compared to healthy control infants on the neurobehavioral measures tested at 12 months of age. These results indicate that at 12 months of age, infants with asymptomatic cCMV are not statistically different from controls in a number of neurobehavioral domains. Although follow-up is ongoing, these observations provide reassurance about neurobehavioral outcomes for infants with asymptomatic cCMV and inform the ongoing discussion around universal screening. Additional follow-up will be necessary to understand the longer-term outcomes of these children.
先天性巨细胞病毒(cCMV)是美国最常见的先天性病毒感染。无症状感染可导致严重听力损失和神经系统残疾,但约 90% 的 cCMV 感染在出生时无症状。尽管该病很普遍,但无症状 cCMV 感染对神经行为的长期风险尚未完全明了。这项研究的目的是评估无症状 cCMV 感染婴儿的潜在长期神经行为后遗症。在美国中西部一个大都会地区进行的新生儿 cCMV 普遍筛查研究中,发现了感染 cCMV 的婴儿。患有 cCMV 的无症状婴儿参加了一项纵向神经发育研究(N = 29)。年龄和性别匹配的健康对照组婴儿(N = 193)是从婴儿连接组项目(BCP)中确定的,该项目是一项关于大脑和行为发育的纵向研究。BCP 样本补充了另外一组健康对照婴儿(N = 30),这组婴儿是从与 BCP 相同的参与者登记处招募的,专门用于与无症状 cCMV 婴儿进行比较。在婴儿 12 个月大时进行神经行为评估和家长问卷调查,包括穆伦早期学习量表(Mullen Scales of Early Learning)、幼儿重复行为量表(RBS-EC)和婴幼儿社会情感评估(ITSEA)。将患有无症状 cCMV 的婴儿与所有已确定的健康对照组婴儿的神经行为评分进行比较。与健康对照组婴儿相比,无症状 cCMV 患儿在 12 个月大时的神经行为测试中表现相当。这些结果表明,12 个月大时,患有无症状 cCMV 的婴儿在一些神经行为领域与对照组婴儿没有统计学差异。虽然后续研究仍在进行中,但这些观察结果为患有无症状 cCMV 的婴儿的神经行为结果提供了保证,并为正在进行的有关普遍筛查的讨论提供了信息。要了解这些儿童的长期结果,还需要进行更多的随访。
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引用次数: 0
Exploring an objective measure of overactivity in children with rare genetic syndromes 探索罕见遗传综合征儿童过度活跃的客观测量方法
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-18 DOI: 10.1186/s11689-024-09535-y
Rory O’Sullivan, Stacey Bissell, Georgie Agar, Jayne Spiller, Andrew Surtees, Mary Heald, Emma Clarkson, Aamina Khan, Christopher Oliver, Andrew P. Bagshaw, Caroline Richards
Overactivity is prevalent in several rare genetic neurodevelopmental syndromes, including Smith-Magenis syndrome, Angelman syndrome, and tuberous sclerosis complex, although has been predominantly assessed using questionnaire techniques. Threats to the precision and validity of questionnaire data may undermine existing insights into this behaviour. Previous research indicates objective measures, namely actigraphy, can effectively differentiate non-overactive children from those with attention-deficit hyperactivity disorder. This study is the first to examine the sensitivity of actigraphy to overactivity across rare genetic syndromes associated with intellectual disability, through comparisons with typically-developing peers and questionnaire overactivity estimates. A secondary analysis of actigraphy data and overactivity estimates from The Activity Questionnaire (TAQ) was conducted for children aged 4-15 years with Smith-Magenis syndrome (N=20), Angelman syndrome (N=26), tuberous sclerosis complex (N=16), and typically-developing children (N=61). Actigraphy data were summarized using the M10 non-parametric circadian rhythm variable, and 24-hour activity profiles were modelled via functional linear modelling. Associations between actigraphy data and TAQ overactivity estimates were explored. Differences in actigraphy-defined activity were also examined between syndrome and typically-developing groups, and between children with high and low TAQ overactivity scores within syndromes. M10 and TAQ overactivity scores were strongly positively correlated for children with Angelman syndrome and Smith-Magenis syndrome. M10 did not substantially differ between the syndrome and typically-developing groups. Higher early morning activity and lower evening activity was observed across all syndrome groups relative to typically-developing peers. High and low TAQ group comparisons revealed syndrome-specific profiles of overactivity, persisting throughout the day in Angelman syndrome, occurring during the early morning and early afternoon in Smith-Magenis syndrome, and manifesting briefly in the evening in tuberous sclerosis complex. These findings provide some support for the sensitivity of actigraphy to overactivity in children with rare genetic syndromes, and offer syndrome-specific temporal descriptions of overactivity. The findings advance existing descriptions of overactivity, provided by questionnaire techniques, in children with rare genetic syndromes and have implications for the measurement of overactivity. Future studies should examine the impact of syndrome-related characteristics on actigraphy-defined activity and overactivity estimates from actigraphy and questionnaire techniques.
过度活动在几种罕见的遗传性神经发育综合征(包括史密斯-马盖尼综合征、安格曼综合征和结节性硬化症综合征)中非常普遍,但主要是通过问卷技术进行评估。问卷数据的精确性和有效性受到威胁,这可能会破坏对这一行为的现有认识。以往的研究表明,客观的测量方法,即行为测量法,可以有效地区分非多动儿童和注意力缺陷多动障碍儿童。本研究首次通过与发育正常的同龄人进行比较和问卷调查过动估计值,研究了行为测量法对与智力障碍相关的罕见遗传综合征的过动敏感性。我们对 4-15 岁患有史密斯-马盖尼综合征(20 人)、安格曼综合征(26 人)、结节性硬化症综合征(16 人)的儿童以及发育正常的儿童(61 人)的活动图数据和活动问卷(TAQ)过度活动估计值进行了二次分析。动图数据采用 M10 非参数昼夜节律变量进行汇总,并通过功能线性模型对 24 小时活动情况进行建模。研究探讨了活动图数据与 TAQ 过度活动估计值之间的关联。此外,还研究了综合征组和发育正常组之间,以及综合征中TAQ过度活动评分高和低的儿童之间,由动电图定义的活动量的差异。安杰尔曼综合症和史密斯-马盖尼斯综合症患儿的 M10 和 TAQ 过度活跃评分呈强正相关。M10 在综合征组和发育典型组之间没有实质性差异。与发育正常的同龄人相比,所有综合症患儿组清晨活动较多,傍晚活动较少。高 TAQ 组和低 TAQ 组的比较显示,过度活动具有综合征的特异性,安杰尔曼综合征的过度活动持续一整天,史密斯-马吉尼斯综合征的过度活动发生在清晨和下午早些时候,而结节性硬化综合征的过度活动则在傍晚短暂出现。这些发现在一定程度上支持了动作描记术对罕见遗传综合征患儿过度活动的敏感性,并提供了综合征特有的过度活动时间描述。这些发现推进了现有的通过问卷技术对罕见遗传综合征儿童过度活动的描述,并对过度活动的测量产生了影响。未来的研究应考察综合征相关特征对动电学定义的活动量以及动电学和问卷技术对过度活动的估计值的影响。
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引用次数: 0
The Brain Gene Registry: a data snapshot 大脑基因登记:数据快照
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-17 DOI: 10.1186/s11689-024-09530-3
Dustin Baldridge, Levi Kaster, Catherine Sancimino, Siddharth Srivastava, Sophie Molholm, Aditi Gupta, Inez Oh, Virginia Lanzotti, Daleep Grewal, Erin Rooney Riggs, Juliann M. Savatt, Rachel Hauck, Abigail Sveden, John N. Constantino, Joseph Piven, Christina A. Gurnett, Maya Chopra, Heather Hazlett, Philip R. O. Payne
Monogenic disorders account for a large proportion of population-attributable risk for neurodevelopmental disabilities. However, the data necessary to infer a causal relationship between a given genetic variant and a particular neurodevelopmental disorder is often lacking. Recognizing this scientific roadblock, 13 Intellectual and Developmental Disabilities Research Centers (IDDRCs) formed a consortium to create the Brain Gene Registry (BGR), a repository pairing clinical genetic data with phenotypic data from participants with variants in putative brain genes. Phenotypic profiles are assembled from the electronic health record (EHR) and a battery of remotely administered standardized assessments collectively referred to as the Rapid Neurobehavioral Assessment Protocol (RNAP), which include cognitive, neurologic, and neuropsychiatric assessments, as well as assessments for attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Co-enrollment of BGR participants in the Clinical Genome Resource’s (ClinGen’s) GenomeConnect enables display of variant information in ClinVar. The BGR currently contains data on 479 participants who are 55% male, 6% Asian, 6% Black or African American, 76% white, and 12% Hispanic/Latine. Over 200 genes are represented in the BGR, with 12 or more participants harboring variants in each of these genes: CACNA1A, DNMT3A, SLC6A1, SETD5, and MYT1L. More than 30% of variants are de novo and 43% are classified as variants of uncertain significance (VUSs). Mean standard scores on cognitive or developmental screens are below average for the BGR cohort. EHR data reveal developmental delay as the earliest and most common diagnosis in this sample, followed by speech and language disorders, ASD, and ADHD. BGR data has already been used to accelerate gene-disease validity curation of 36 genes evaluated by ClinGen’s BGR Intellectual Disability (ID)-Autism (ASD) Gene Curation Expert Panel. In summary, the BGR is a resource for use by stakeholders interested in advancing translational research for brain genes and continues to recruit participants with clinically reported variants to establish a rich and well-characterized national resource to promote research on neurodevelopmental disorders.
在神经发育障碍的人群归因风险中,单基因疾病占了很大比例。然而,推断特定基因变异与特定神经发育障碍之间因果关系所需的数据往往缺乏。认识到这一科学障碍后,13 个智力和发育障碍研究中心(IDDRCs)组成了一个联盟,创建了脑基因注册中心(BGR),这是一个将临床基因数据与推测脑基因变异参与者的表型数据配对的存储库。表型档案由电子健康记录(EHR)和一系列远程管理的标准化评估(统称为快速神经行为评估协议(RNAP))组成,其中包括认知、神经和神经精神评估,以及注意缺陷多动障碍(ADHD)和自闭症谱系障碍(ASD)评估。BGR 参与者共同加入临床基因组资源(ClinGen)的 GenomeConnect 后,可在 ClinVar 中显示变异信息。BGR 目前包含 479 名参与者的数据,其中 55% 为男性,6% 为亚裔,6% 为黑人或非裔美国人,76% 为白人,12% 为西班牙裔/拉丁裔。BGR 中包含 200 多个基因,每个基因中都有 12 个或更多参与者携带变异:CACNA1A、DNMT3A、SLC6A1、SETD5 和 MYT1L。30%以上的变异为新变异,43%的变异被归类为意义不确定的变异(VUS)。认知或发育筛查的平均标准分低于 BGR 群体的平均水平。电子病历数据显示,发育迟缓是该样本中最早和最常见的诊断,其次是言语和语言障碍、ASD 和多动症。BGR数据已被用于加速ClinGen的BGR智力障碍(ID)-自闭症(ASD)基因编辑专家小组评估的36个基因的基因-疾病有效性编辑。总之,BGR 是供有志于推动脑部基因转化研究的利益相关者使用的资源,它将继续招募具有临床报告变异的参与者,以建立一个内容丰富、特征清晰的全国性资源,促进神经发育疾病的研究。
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引用次数: 0
Characterization of early markers of disease in the mouse model of mucopolysaccharidosis IIIB 粘多糖病IIIB小鼠模型的早期疾病标志物特征描述
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-17 DOI: 10.1186/s11689-024-09534-z
Katherine B. McCullough, Amanda Titus, Kate Reardon, Sara Conyers, Joseph D. Dougherty, Xia Ge, Joel R. Garbow, Patricia Dickson, Carla M. Yuede, Susan E. Maloney
Mucopolysaccharidosis (MPS) IIIB, also known as Sanfilippo Syndrome B, is a devastating childhood disease. Unfortunately, there are currently no available treatments for MPS IIIB patients. Yet, animal models of lysosomal storage diseases have been valuable tools in identifying promising avenues of treatment. Enzyme replacement therapy, gene therapy, and bone marrow transplant have all shown efficacy in the MPS IIIB model systems. A ubiquitous finding across rodent models of lysosomal storage diseases is that the best treatment outcomes resulted from intervention prior to symptom onset. Therefore, the aim of the current study was to identify early markers of disease in the MPS IIIB mouse model as well as examine clinically-relevant behavioral domains not yet explored in this model. Using the MPS IIIB mouse model, we explored early developmental trajectories of communication and gait, and later social behavior, fear-related startle and conditioning, and visual capabilities. In addition, we examined brain structure and function via magnetic resonance imaging and diffusion tensor imaging. We observed reduced maternal isolation-induced ultrasonic vocalizations in MPS IIIB mice relative to controls, as well as disruption in a number of the spectrotemporal features. MPS IIIB also exhibited disrupted thermoregulation during the first two postnatal weeks without any differences in body weight. The developmental trajectories of gait were largely normal. In early adulthood, we observed intact visual acuity and sociability yet a more submissive phenotype, increased aggressive behavior, and decreased social sniffing relative to controls. MPS IIIB mice showed greater inhibition of startle in response to a pretone with a decrease in overall startle response and reduced cued fear memory. MPS IIIB also weighed significantly more than controls throughout adulthood and showed larger whole brain volumes and normalized regional volumes with intact tissue integrity as measured with magnetic resonance and diffusion tensor imaging, respectively. Together, these results indicate disease markers are present as early as the first two weeks postnatal in this model. Further, this model recapitulates social, sensory and fear-related clinical features. Our study using a mouse model of MPS IIIB provides essential baseline information that will be useful in future evaluations of potential treatments.
粘多糖病(MPS)IIIB,又称桑菲利波综合征 B,是一种毁灭性的儿童疾病。遗憾的是,目前还没有针对 MPS IIIB 患者的治疗方法。然而,溶酶体贮积疾病的动物模型一直是确定有希望的治疗途径的宝贵工具。酶替代疗法、基因疗法和骨髓移植在 MPS IIIB 模型系统中均显示出疗效。溶酶体储积症啮齿类动物模型的一个普遍发现是,在症状出现前进行干预可获得最佳治疗效果。因此,本研究旨在确定 MPS IIIB 小鼠模型中的早期疾病标志物,并检查该模型中尚未探索的与临床相关的行为领域。利用 MPS IIIB 小鼠模型,我们探索了交流和步态的早期发育轨迹,以及后来的社交行为、与恐惧相关的惊吓和条件反射以及视觉能力。此外,我们还通过磁共振成像和弥散张量成像检查了大脑结构和功能。与对照组相比,我们观察到 MPS IIIB 小鼠母体隔离诱导的超声波发声减少,而且一些频谱时相特征受到破坏。在出生后的头两周,MPS IIIB 还表现出体温调节紊乱,但体重没有任何差异。步态的发育轨迹基本正常。在成年早期,我们观察到小鼠的视敏度和社交能力完好,但与对照组相比,表型更加顺从,攻击行为增加,社交嗅觉减少。MPS IIIB 小鼠对预音的惊吓抑制更强,但总体惊吓反应却有所下降,提示性恐惧记忆也有所减少。MPS IIIB 在整个成年期的体重也明显高于对照组,而且通过磁共振和弥散张量成像测量,MPS IIIB 的全脑体积和正常化区域体积更大,组织完整性完好。这些结果表明,在该模型中,疾病标志物早在出生后两周就已出现。此外,该模型还再现了社交、感觉和恐惧相关的临床特征。我们使用 MPS IIIB 小鼠模型进行的研究提供了重要的基线信息,这些信息将有助于未来对潜在治疗方法的评估。
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引用次数: 0
Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions ADNP、CHD8 和 DYRK1A 相关神经发育疾病的共同和不同心理健康特征
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-15 DOI: 10.1186/s11689-024-09532-1
Emily Neuhaus, Hannah Rea, Elizabeth Jones, Hannah Benavidez, Conor Miles, Alana Whiting, Margaret Johansson, Curtis Eayrs, Evangeline C. Kurtz-Nelson, Rachel Earl, Raphael A. Bernier, Evan E. Eichler
Neurodevelopmental conditions such as intellectual disability (ID) and autism spectrum disorder (ASD) can stem from a broad array of inherited and de novo genetic differences, with marked physiological and behavioral impacts. We currently know little about the psychiatric phenotypes of rare genetic variants associated with ASD, despite heightened risk of psychiatric concerns in ASD more broadly. Understanding behavioral features of these variants can identify shared versus specific phenotypes across gene groups, facilitate mechanistic models, and provide prognostic insights to inform clinical practice. In this paper, we evaluate behavioral features within three gene groups associated with ID and ASD – ADNP, CHD8, and DYRK1A – with two aims: (1) characterize phenotypes across behavioral domains of anxiety, depression, ADHD, and challenging behavior; and (2) understand whether age and early developmental milestones are associated with later mental health outcomes. Phenotypic data were obtained for youth with disruptive variants in ADNP, CHD8, or DYRK1A (N = 65, mean age = 8.7 years, 40% female) within a long-running, genetics-first study. Standardized caregiver-report measures of mental health features (anxiety, depression, attention-deficit/hyperactivity, oppositional behavior) and developmental history were extracted and analyzed for effects of gene group, age, and early developmental milestones on mental health features. Patterns of mental health features varied by group, with anxiety most prominent for CHD8, oppositional features overrepresented among ADNP, and attentional and depressive features most prominent for DYRK1A. For the full sample, age was positively associated with anxiety features, such that elevations in anxiety relative to same-age and same-sex peers may worsen with increasing age. Predictive utility of early developmental milestones was limited, with evidence of early language delays predicting greater difficulties across behavioral domains only for the CHD8 group. Despite shared associations with autism and intellectual disability, disruptive variants in ADNP, CHD8, and DYRK1A may yield variable psychiatric phenotypes among children and adolescents. With replication in larger samples over time, efforts such as these may contribute to improved clinical care for affected children and adolescents, allow for earlier identification of emerging mental health difficulties, and promote early intervention to alleviate concerns and improve quality of life.
智力障碍(ID)和自闭症谱系障碍(ASD)等神经发育疾病可能源于一系列遗传和新发基因差异,并对生理和行为产生明显影响。目前,我们对与 ASD 相关的罕见遗传变异的精神表型知之甚少,尽管 ASD 更广泛地存在精神问题的风险增加。了解这些变异体的行为特征可以识别不同基因组的共同表型和特殊表型,促进机理模型的建立,并为临床实践提供预后见解。在本文中,我们评估了与 ID 和 ASD 相关的三个基因组(ADNP、CHD8 和 DYRK1A)的行为特征,目的有两个:(1)描述焦虑、抑郁、ADHD 和挑战行为等行为领域的表型特征;(2)了解年龄和早期发育里程碑是否与日后的心理健康结果相关。在一项长期的遗传学先行研究中,我们获得了患有 ADNP、CHD8 或 DYRK1A 破坏性变异的青少年的表型数据(N = 65,平均年龄 = 8.7 岁,40% 为女性)。研究人员提取了护理人员报告的心理健康特征(焦虑、抑郁、注意力缺陷/多动、对抗行为)和发育史的标准化测量数据,并分析了基因组、年龄和早期发育里程碑对心理健康特征的影响。心理健康特征的模式因基因组而异,焦虑在 CHD8 中最为突出,对抗行为特征在 ADNP 中比例较高,而注意力和抑郁特征在 DYRK1A 中最为突出。在全部样本中,年龄与焦虑特征呈正相关,因此,与同龄和同性同伴相比,焦虑的增加可能会随着年龄的增加而加剧。早期发育里程碑的预测作用有限,只有 CHD8 组的早期语言发育迟缓能预测出行为领域的更大困难。尽管ADNP、CHD8和DYRK1A中的破坏性变异与自闭症和智障有共同的关联,但它们可能会在儿童和青少年中产生不同的精神表型。随着时间的推移,在更大的样本中进行复制,这样的努力可能有助于改善受影响儿童和青少年的临床治疗,允许更早地识别新出现的心理健康问题,并促进早期干预,以减轻忧虑和提高生活质量。
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引用次数: 0
Neurofeedback training of executive function in autism spectrum disorder: distinct effects on brain activity levels and compensatory connectivity changes 自闭症谱系障碍患者执行功能的神经反馈训练:对大脑活动水平和代偿连接变化的独特影响
IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-11 DOI: 10.1186/s11689-024-09531-2
Daniela Jardim Pereira, Sofia Morais, Alexandre Sayal, João Pereira, Sofia Meneses, Graça Areias, Bruno Direito, António Macedo, Miguel Castelo-Branco
Deficits in executive function (EF) are consistently reported in autism spectrum disorders (ASD). Tailored cognitive training tools, such as neurofeedback, focused on executive function enhancement might have a significant impact on the daily life functioning of individuals with ASD. We report the first real-time fMRI neurofeedback (rt-fMRI NF) study targeting the left dorsolateral prefrontal cortex (DLPFC) in ASD. Thirteen individuals with autism without intellectual disability and seventeen neurotypical individuals completed a rt-fMRI working memory NF paradigm, consisting of subvocal backward recitation of self-generated numeric sequences. We performed a region-of-interest analysis of the DLPFC, whole-brain comparisons between groups and, DLPFC-based functional connectivity. The ASD and control groups were able to modulate DLPFC activity in 84% and 98% of the runs. Activity in the target region was persistently lower in the ASD group, particularly in runs without neurofeedback. Moreover, the ASD group showed lower activity in premotor/motor areas during pre-neurofeedback run than controls, but not in transfer runs, where it was seemingly balanced by higher connectivity between the DLPFC and the motor cortex. Group comparison in the transfer run also showed significant differences in DLPFC-based connectivity between groups, including higher connectivity with areas integrated into the multidemand network (MDN) and the visual cortex. Neurofeedback seems to induce a higher between-group similarity of the whole-brain activity levels (including the target ROI) which might be promoted by changes in connectivity between the DLPFC and both high and low-level areas, including motor, visual and MDN regions.
据报道,自闭症谱系障碍(ASD)患者普遍存在执行功能(EF)缺陷。神经反馈等以增强执行功能为重点的定制认知训练工具可能会对自闭症谱系障碍患者的日常生活功能产生重大影响。我们报告了第一项针对 ASD 患者左侧背外侧前额叶皮层(DLPFC)的实时 fMRI 神经反馈(rt-fMRI NF)研究。13 名无智力障碍的自闭症患者和 17 名神经畸形患者完成了一项 rt-fMRI 工作记忆 NF 范例,该范例包括对自我生成的数字序列进行次发声背诵。我们对 DLPFC 进行了兴趣区分析,并进行了组间全脑比较和基于 DLPFC 的功能连接。ASD 组和对照组分别能在 84% 和 98% 的运行中调节 DLPFC 的活动。ASD 组的目标区域活动持续较低,尤其是在没有神经反馈的运行中。此外,与对照组相比,ASD 组在神经反馈前的运行中显示出较低的运动前/运动区活动,但在转移运行中却没有显示出较低的活动,而在转移运行中,DLPFC 与运动皮层之间较高的连通性似乎平衡了这一活动。转运过程中的组间比较也表明,组间基于 DLPFC 的连通性存在显著差异,包括与多指令网络(MDN)和视觉皮层整合区域的连通性更高。神经反馈似乎诱导了组间更高的全脑活动水平相似性(包括目标 ROI),这可能是由于 DLPFC 与高水平和低水平区域(包括运动、视觉和 MDN 区域)之间的连通性发生了变化。
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Journal of Neurodevelopmental Disorders
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