PDF(Pubmed)
Abstract：
Autism spectrum disorders (ASDs) and functional neurological disorders (FNDs) share some clinical characteristics such as alexithymia, sensory sensitivity and interoceptive issues. Recent evidence shows that both the disorders present symptoms compatible with a diagnosis of hypermobile Ehlers-Danlos Syndrome and hypermobile spectrum disorders (hEDS/HSD), a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Here we compared the prevalence of hEDS/HSD-related symptoms in a group of patients with FNDs, of people with ASDs without intellectual disabilities, and a non-clinical comparison group (NC). Twenty patients with FNDs, 27 individuals with ASDs without intellectual disabilities and 26 NC were recruited and completed the Self-reported screening questionnaire for the assessment of hEDS/HSD-related symptoms (SQ-CH). We found that 55% of the patients with FNDs, 44.4% of the individuals with ASDs and 30.8% of NC scored above the cut-off at the SQ-CH; SQ-CH scores of both FNDs and ASDs group were significantly higher than the NC group\'s ones. In conclusion, both ASDs and FNDs individuals present hEDS/HSD-related symptoms in a higher number than the general population. Imputable mechanisms include (i) overwhelming of executive functions with consequent motor competence impairment for ASDs individuals, and (ii) exacerbation of FNDs symptoms by physical injury and chronic pain due to abnormal range of joint mobility. Moreover, we speculated that the amygdala and the anterior cingulate cortex circuitry might be responsible for the imbalances at the proprioceptive, interoceptive, and emotional levels.
摘要：
孤独症谱系障碍（ASDs）和功能性神经障碍（FNDs）具有一些临床特征，例如述情障碍，感官敏感性和互感问题。最近的证据表明，这两种疾病的症状都与超移动Ehlers-Danlos综合征和超移动频谱障碍（hEDS/HSD）的诊断相符。一组异质性的遗传性结缔组织疾病，以关节过度活动为特征，皮肤过度伸展性，组织脆弱.在这里，我们比较了一组FND患者中hEDS/HSD相关症状的患病率，没有智力障碍的自闭症患者，和非临床对照组（NC）。20名FND患者，招募了27名无智力障碍的ASD患者和26名NC，并完成了自我报告筛查问卷，以评估hEDS/HSD相关症状（SQ-CH）。我们发现55%的FND患者，在SQ-CH时，有44.4％的ASD个体和30.8％的NC得分高于临界值；FND和ASD组的SQ-CH得分均显着高于NC组。总之,ASD和FND个体出现hEDS/HSD相关症状的人数均高于普通人群。可归责机制包括（i）压倒性的执行功能，从而导致ASD个体的运动能力受损，和(ii)由于关节活动度范围异常而导致的身体损伤和慢性疼痛加重FND症状。此外，我们推测杏仁核和前扣带回皮质回路可能是造成本体感觉失衡的原因，互感，和情感水平。
