Autism spectrum disorder (ASD)

自闭症谱系障碍 ( ASD )
  • 文章类型: Case Reports
    目前,精神病学界的共识是,接受发育迟缓和/或自闭症谱系障碍(ASD)评估的儿童应在诊断过程的早期进行基因检测。识别遗传异常可以提供对患者预后的了解,并可能揭示可能在患者一生中出现的其他医学并发症。尽管有这些公认的好处,基因检测通常被延迟或不提供,因此剥夺了家庭对孩子未来健康结果的宝贵知识。我们介绍了一例6岁的患者,他向我们的儿童和青少年精神病学办公室提出了行为问题。她在就诊前几年接受了ASD诊断,但由于未知的原因,从未进行过基因检测。基因检测是在我们办公室进行的,结果显示,三种不同的突变与ASD和包括癫痫在内的各种其他医学并发症有关。有了这些知识,患者的家人对孩子的预后有了重要的了解。此案例强调了在评估发育迟缓和/或ASD儿童时采用即时测试(POCT)模型的必要性。通过这个模型,在这些患者的初次就诊期间,将向家庭提供基因检测。这将有助于简化这一过程,并允许更广泛地检测与ASD和共存的医学后遗症相关的遗传疾病。拥有这些知识将使家庭更好地了解孩子的状况,并允许家庭与提供者一起确定最佳治疗计划。
    It is the current consensus amongst the psychiatric community that children undergoing evaluation for developmental delays and/or autism spectrum disorder (ASD) should be offered genetic testing early in the diagnostic process. Identifying genetic abnormalities can provide insight into patient prognosis and may reveal other medical complications that could arise throughout a patient\'s life. Despite these recognized benefits, genetic testing is often delayed or not offered and therefore deprives families of valuable knowledge about their child\'s future health outcomes. We present a case of a six-year-old patient who presented to our child and adolescent psychiatry office for behavioral concerns. She had received an ASD diagnosis years prior to presentation, but for unknown reasons, genetic testing had never been pursued. Genetic testing was obtained in our office, and the results revealed three different mutations that were linked to ASD and various other medical complications including epilepsy. With this knowledge, the patient\'s family gained important insight into their child\'s prognosis. This case highlights the necessity for adopting a point-of-care testing (POCT) model when evaluating children with developmental delays and/or ASD. Through this model, genetic testing would be offered to families during the initial visit for these patients. This would help streamline this process and allow for more widespread detection of genetic disorders linked to ASD and coexisting medical sequelae. Having this knowledge would empower families with a better understanding of their child\'s condition and would allow families to work together with providers to determine the best possible treatment plan.
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  • 文章类型: Journal Article
    这项研究有两个目的。首先,我们的目的是调查ACB的患病率,PCB,与一组没有ASD的儿童相比,一组患有ASD的阿尔巴尼亚儿童的口腔习惯。第二,我们的目标是确定ASD与ACB的关联,PCB,和口腔习惯。样本包括125名自闭症儿童(91名男性,34名女性)来自地拉那的2所残疾儿童特殊学校和2所日常住宿中心。对照组包括125名无ASD儿童。通过卡方检验评估分类变量之间的关系。为了识别ASD的潜在风险因素,我们进行了二元逻辑回归。在初级和青少年牙列阶段之间,CB或口腔习惯没有统计学上的显着差异。比较患有CB和口腔习惯的ASD儿童,发现PCB的患病率存在显着差异。二元Logistic回归显示,ACB,PCB和口腔习惯与ASD无关。CB在原发性和混合牙列阶段的ASD儿童中更为普遍。口腔习惯在混合牙列和青少年牙列阶段更为普遍。然而,ASD不是CB或其他口腔习惯的危险因素。
    This study had two aims. First, we aimed to investigate the prevalence of ACB, PCB, and oral habits among a group of Albanian children with ASD compared with a group of children without ASD. Second, we aimed to identify the associations of ASD with ACB, PCB, and oral habits. The sample inlcuded 125 children with ASD (91 males, 34 females) from 2 special schools for children with disabilities and 2 daily residential centers in Tirana. The control group included 125 children without ASD. The relationships between categorical variables were evaluated via the chi-square test. To identify the potential risk factors for ASD, we performed binary logistic regression. No statistically significant differences were found for CB or oral habits between the primary and adolescent dentition stages. A comparison of children with ASD with CB and oral habits revealed a significant difference in the prevalence of PCB. Binary logistic regression revealed that ACB, PCB and oral habits were not associated with ASD. CB was more prevalent among children with ASD in the primary and mixed dentition stages. Oral habits were more prevalent in the mixed and adolescent dentition stages. However, ASD is not a risk factor for CB or other oral habits.
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  • 文章类型: Journal Article
    越来越多的证据证明自闭症儿童有胃肠道问题。然而,孤独症和非孤独症儿童的肠道菌群(GM)存在显著差异.转基因的这些变化可能源于几个因素。最近,研究人员专注于营养因素,尤其是维生素缺乏。因此,我们的系统综述调查了自闭症之间的联系,GM变更,和维生素A缺乏症(VAD),通过分析2010年至2022年来自PubMed和Embase数据库的研究。坚持PRISMA准则,我们精心挑选了19项相关研究,这些研究确立了自闭症与转基因改变之间或自闭症与VAD之间的联系.我们的发现一致地指出自闭症患者的转基因发生了显着变化,表明这些变化是该疾病的有希望的生物标志物。尽管转基因改变与自闭症有一致的关联,我们的分析显示,自闭症患者和VAD患者的GM成分没有显著差异.这表明VAD,尤其是在生命早期遇到的时候,可能在自闭症的发病中起作用。此外,我们的评论强调了自闭症儿童视黄酸水平降低之间的明显相关性,这可能与自闭症症状的严重程度有关。我们的研究结果是双重的:它们不仅加强了转基因改变作为潜在诊断标志物的重要性,而且突出了进一步研究营养干预措施的迫切需要。具体来说,补充维生素A成为缓解自闭症症状的一个有希望的途径,保证对其治疗潜力进行更深入的调查。
    Accumulating evidence proves that children with autism have gastrointestinal problems. However, a significant difference in gut microbiota (GM) exists between autistic and non-autistic children. These changes in the GM may stem from several factors. Recently, researchers focused on nutritional factors, especially vitamin deficiency. Thus, our systematic review investigates the connections among autism, GM alterations, and vitamin A deficiency (VAD), by analyzing studies sourced from PubMed and Embase databases spanning from 2010 to 2022. Adhering to PRISMA guidelines, we meticulously selected 19 pertinent studies that established links between autism and GM changes or between autism and VAD. Our findings uniformly point to significant alterations in the GM of individuals with autism, indicating these changes as promising biomarkers for the disorder. Despite the consistent association of GM alterations with autism, our analysis revealed no notable differences in GM composition between individuals with autism and those experiencing VAD. This suggests that VAD, especially when encountered early in life, might play a role in the onset of autism. Furthermore, our review underscores a distinct correlation between reduced levels of retinoic acid in children with autism, a disparity that could relate to the severity of autism symptoms. The implications of our findings are twofold: they not only reinforce the significance of GM alterations as potential diagnostic markers but also spotlight the critical need for further research into nutritional interventions. Specifically, vitamin A supplementation emerges as a promising avenue for alleviating autism symptoms, warranting deeper investigation into its therapeutic potential.
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  • 文章类型: Journal Article
    自闭症是一种神经发育障碍,在儿童时期表现在个人身上,对他们的社交互动和交流具有持久的影响。近年来,基于大脑网络和活动差异的个体自闭症谱系障碍(ASD)的预测已经得到了广泛的研究,然而,精度较低。因此,在这项研究中,提出了通过计算机辅助算法在早期阶段进行识别,以区分ASD和TD患者。为了识别特征,开发了多层感知器(MLP)模型,该模型利用逻辑回归对从fMRI图像得出的受试者的连通性矩阵中提取的特征进行分析。通过逻辑回归模型确定了对患有自闭症谱系障碍(ASD)或典型发展(TD)的个体分类有重要贡献的特征。加强对本质属性的重视,一个AND操作是集成的。这涉及选择在对各种随机分布进行的各种逻辑回归分析中证明统计显著性的特征。迭代方法有助于全面理解相关特征以进行准确分类。通过实施这种方法,特征重要性的估计变得更加可靠,并且通过对各种数据子集的模型性能评估来缓和过度拟合的可能性。从实验中观察到,仅在ASD中发现高度相关的左枕骨外侧皮层和右枕骨外侧皮层ROI。此外,注意到高度相关的左小脑扁桃体和右小脑扁桃体仅在TD参与者中发现。在MLP分类器中,召回率达到82.61%,其次是Logistic回归,准确率为72.46%。MLP也以83.57%的准确度和0.978的AUC脱颖而出。
    Autism is a neurodevelopmental disorder that manifests in individuals during childhood and has enduring consequences for their social interactions and communication. The prediction of Autism Spectrum Disorder (ASD) in individuals based on the differences in brain networks and activities have been studied extensively in the recent past, however, with lower accuracies. Therefore in this research, identification at the early stage through computer-aided algorithms to differentiate between ASD and TD patients is proposed. In order to identify features, a Multi-Layer Perceptron (MLP) model is developed which utilizes logistic regression on characteristics extracted from connectivity matrices of subjects derived from fMRI images. The features that significantly contribute to the classification of individuals as having Autism Spectrum Disorder (ASD) or typically developing (TD) are identified by the logistic regression model. To enhance emphasis on essential attributes, an AND operation is integrated. This involves selecting features demonstrating statistical significance across diverse logistic regression analyses conducted on various random distributions. The iterative approach contributes to a comprehensive understanding of relevant features for accurate classification. By implementing this methodology, the estimation of feature importance became more dependable, and the potential for overfitting is moderated through the evaluation of model performance on various subsets of data. It is observed from the experimentation that the highly correlated Left Lateral Occipital Cortex and Right Lateral Occipital Cortex ROIs are only found in ASD. Also, it is noticed that the highly correlated Left Cerebellum Tonsil and Right Cerebellum Tonsil are only found in TD participants. Among the MLP classifier, a recall of 82.61 % is achieved followed by Logistic Regression with an accuracy of 72.46 %. MLP also stands out with a commendable accuracy of 83.57 % and AUC of 0.978.
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  • 文章类型: Journal Article
    背景:照顾患有自闭症谱系障碍(ASD)的儿童是一项具有挑战性和压力的任务,特别是在资源有限的国家。额外的研究是必要的,考虑到ASD儿童的患病率越来越高,增加对ASD儿童看护者面临的复杂困难的了解,并提供对父母利用的应对策略和支持网络的见解。
    目的:这项研究的目的是探索和描述KennethKaunda博士地区ASD儿童看护人的经验和应对机制,西北省,南非。
    方法:定性探索,使用目的抽样技术和半结构化访谈进行了上下文和描述性设计。按照反身性专题分析的六个步骤对数据进行了分析。
    结果:确定了两个主题:照顾者抚养自闭症儿童的经验,和照顾者应对抚养自闭症儿童。
    结论:研究建立了照顾者的经验和应对机制,以抚养患有ASD的孩子,以及对他们生活的不同方面的影响,包括情感,社会和金融方面,这对他们的整体福祉有负面影响。这些障碍需要建立情感支持小组,通过开展运动,对家庭和社区进行各种挑战的教育,增强护理人员的权能和提高认识。贡献:这项研究的结果有助于更深入地了解ASD儿童看护者面临的多方面挑战,并提供对这些看护者在社会生态背景下采用的支持系统和应对机制的见解。
    BACKGROUND:  Caring for a child with autism spectrum disorder (ASD) is a challenging and stressful task, especially in countries with limited resources. Additional research is necessary, considering the increasing prevalence of children with ASD, to gain increased knowledge of the complex difficulties faced by caregivers of ASD children and to offer insights into the coping strategies and support networks that parents utilise.
    OBJECTIVE:  The objective of this study was to explore and describe the experiences and coping mechanisms of caregivers of children with ASD in Dr Kenneth Kaunda district, North West province, South Africa.
    METHODS:  Qualitative explorative, contextual and descriptive design with purposive sampling technique and semi-structured interviews were conducted. Data were analysed following the six steps of reflexive thematic analysis.
    RESULTS:  Two themes were identified: Caregivers\' experiences in raising a child with autism, and caregivers\' coping in raising a child with autism.
    CONCLUSIONS:  The research established caregivers\' experiences and coping mechanisms in raising a child with ASD and the effects on different aspects of their lives including emotional, social and financial aspects, which contribute negatively to their holistic well-being. These impediments warrant the establishment of emotional support groups, empowerment of caregivers and awareness-raising through campaigns to educate the family and the community on the diverse challenges.Contribution: The findings of this study contribute to a deeper understanding of the multifaceted challenges faced by caregivers of children with ASD and provide insights into the support systems and coping mechanisms employed by these caregivers within the socio-ecological context.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是一种神经发育障碍;其患病率一直在上升,原因不明。在ASD患者中,肠脑轴的改变已得到广泛认可。和益生菌被认为可能有利于拯救自闭症样行为。然而,多种益生菌对斑马鱼模型的有效性和作用机制尚不清楚。本研究旨在使用无菌(GF)和常规饲养(CR)AB野生型斑马鱼以及突变体Tbr1b-/-和Katnal2-/-系作为人类相关的ASD动物模型,以评估多种益生菌对减轻发育和行为缺陷的影响。结果表明,益生菌的添加增加了基本的重要发育指标,例如身体长度,体重,和处理过的斑马鱼的存活率。此外,植物乳杆菌和鼠李糖乳杆菌通过增加其流动性来影响CR斑马鱼的行为,降低GF斑马鱼的躁狂,减轻转基因斑马鱼的异常行为。此外,γ-氨基丁酸(GABA)相关关键基因的表达水平,多巴胺(DA),和5-羟色胺(5-HT)作为影响自闭症相关疾病的出现和发展的重要神经途径,包括gad1b,tph1a,htr3a,th,和slc6a3,在某种程度上被一些益生菌治疗显著激活。一起来看,这项研究表明了不同益生菌的有益作用,这可能为益生菌在相关疾病治疗中的功能提供了新的理解。
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder; the prevalence of which has been on the rise with unknown causes. Alterations in the gut-brain axis have been widely recognized in ASD patients, and probiotics are considered to potentially benefit the rescuing of autism-like behaviors. However, the effectiveness and mechanisms of multiple probiotics on zebrafish models are still not clearly revealed. This study aims to use the germ-free (GF) and conventionally raised (CR) AB wild-type zebrafish and the mutant Tbr1b-/- and Katnal2-/- lines as human-linked ASD animal models to evaluate the effects of multiple probiotics on mitigating developmental and behavioral defects. Results showed that the addition of probiotics increased the basic important developmental indexes, such as body length, weight, and survival rate of treated zebrafish. Moreover, the Lactobacillus plantarum and Lactobacillus rhamnosus affected the behavior of CR zebrafish by increasing their mobility, lowering the GF zebrafish manic, and mitigating transgenic zebrafish abnormal behavior. Moreover, the expression levels of key genes related to gamma-aminobutyric acid (GABA), dopamine (DA), and serotonin (5-HT) as important neuropathways to influence the appearance and development of autism-related disorders, including gad1b, tph1a, htr3a, th, and slc6a3, were significantly activated by some of the probiotics\' treatment at some extent. Taken together, this study indicates the beneficial effects of different probiotics, which may provide a novel understanding of probiotic function in related diseases\' therapy.
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  • 文章类型: Journal Article
    这项初步研究试图在与自闭症谱系障碍(ASD)相关的两个超罕见单基因人群中使用脑电图(EEG)和眼动追踪来评估注意力的生物标志物。相对于特发性ASD(n=12)和神经典型比较(n=49)组,单基因组观察到不同的注意力分布,因此,DYRK1A(n=9)的个体在奇球EEG范式中表现出听觉注意力状况差异减少,而SCN2A(n=5)的个体在观看社交互动时通过眼睛注视跟踪发现视觉注意力状况差异减少。研究结果为特发性ASD和神经典型发育中听觉和视觉注意标记的对齐提供了初步支持,而不是单基因组。这些结果支持正在努力开发注意力领域内的翻译ASD生物标志物。
    This preliminary study sought to assess biomarkers of attention using electroencephalography (EEG) and eye tracking in two ultra-rare monogenic populations associated with autism spectrum disorder (ASD). Relative to idiopathic ASD (n = 12) and neurotypical comparison (n = 49) groups, divergent attention profiles were observed for the monogenic groups, such that individuals with DYRK1A (n = 9) exhibited diminished auditory attention condition differences during an oddball EEG paradigm whereas individuals with SCN2A (n = 5) exhibited diminished visual attention condition differences noted by eye gaze tracking when viewing social interactions. Findings provide initial support for alignment of auditory and visual attention markers in idiopathic ASD and neurotypical development but not monogenic groups. These results support ongoing efforts to develop translational ASD biomarkers within the attention domain.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)的主要特征是社交技能的核心缺陷,通信,和认知,以及重复的刻板行为。这些表现在个体之间是可变的,ASD发病机制复杂,有一千多个相关基因,许多表观遗传因素,和多种环境影响。中脑边缘多巴胺(DA)介导的大脑奖励系统发挥着关键作用,但是迅速发展的文献揭示了复杂的,涉及广泛的中胚层基因座的细微差别信号,神经递质和受体亚型,和神经元变异。改变的DA信号如何构成ASD的多种因果起源的下游收敛还没有很好地理解。ASD发病机制的清晰工作框架可能有助于描绘共同阶段以及潜在的诊断和介入机会。因此,我们在更新ASD奖励信号的新兴数据和观点的背景下总结了ASD的已知自然史。然后,在这种背景下,我们提供了一个临时框架,将ASD发病机制组织成连续的水平,包括(1)遗传和表观遗传变化,(2)中胚层奖励信号通路中断,(3)神经递质/DA信号传导失调,最后,(4)改变神经认知和社会行为以及可能的基于拮抗剂/激动剂的ASD干预。将ASD细分为潜在可寻址部分的逻辑进展可能有助于促进诊断和靶向治疗的合理制定。
    Autism spectrum disorder (ASD) is primarily characterized by core deficits in social skills, communication, and cognition and by repetitive stereotyped behaviors. These manifestations are variable between individuals, and ASD pathogenesis is complex, with over a thousand implicated genes, many epigenetic factors, and multiple environmental influences. The mesolimbic dopamine (DA) mediated brain reward system is held to play a key role, but the rapidly expanding literature reveals intricate, nuanced signaling involving a wide array of mesolimbic loci, neurotransmitters and receptor subtypes, and neuronal variants. How altered DA signaling may constitute a downstream convergence of the manifold causal origins of ASD is not well understood. A clear working framework of ASD pathogenesis may help delineate common stages and potential diagnostic and interventional opportunities. Hence, we summarize the known natural history of ASD in the context of emerging data and perspectives to update ASD reward signaling. Then, against this backdrop, we proffer a provisional framework that organizes ASD pathogenesis into successive levels, including (1) genetic and epigenetic changes, (2) disrupted mesolimbic reward signaling pathways, (3) dysregulated neurotransmitter/DA signaling, and finally, (4) altered neurocognitive and social behavior and possible antagonist/agonist based ASD interventions. This subdivision of ASD into a logical progression of potentially addressable parts may help facilitate the rational formulation of diagnostics and targeted treatments.
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  • 文章类型: Journal Article
    目的:一些研究假设,在自闭症谱系障碍(ASD)儿童中,听觉皮层δ频段的非典型神经同步与语音和语言技能有关。但它仍然知之甚少。这项研究调查了这种神经活动,并探讨了ASD儿童的听觉反应与行为测量之间的关系。
    方法:我们使用脑磁图和个体脑模型研究了20名患有ASD的小学学龄儿童和20名年龄匹配的典型发展(TD)对照的2Hz听觉稳态反应(ASSR)。
    结果:首先,我们发现听觉反应的位置存在组间差异,因此,与ASD儿童相比,TD儿童的2HzASSR拓扑更优越和更靠后。第二,ASD组2HzASSR的功率降低。最后,我们观察到ASD患儿的神经反应幅度与语言技能之间存在显著关联.
    结论:该研究提供了ASD儿童神经反应降低的证据及其与语言技能的关系。
    结论:这些发现可能为未来针对ASD人群的听觉和语言障碍的干预提供依据。
    OBJECTIVE: Some studies have hypothesized that atypical neural synchronization at the delta frequency band in the auditory cortex is associated with phonological and language skills in children with Autism Spectrum Disorder (ASD), but it is still poorly understood. This study investigated this neural activity and addressed the relationships between auditory response and behavioral measures of children with ASD.
    METHODS: We used magnetoencephalography and individual brain models to investigate 2 Hz Auditory Steady-State Response (ASSR) in 20 primary-school-aged children with ASD and 20 age-matched typically developing (TD) controls.
    RESULTS: First, we found a between-group difference in the localization of the auditory response, so as the topology of 2 Hz ASSR was more superior and posterior in TD children when comparing to children with ASD. Second, the power of 2 Hz ASSR was reduced in the ASD group. Finally, we observed a significant association between the amplitude of neural response and language skills in children with ASD.
    CONCLUSIONS: The study provided the evidence of reduced neural response in children with ASD and its relation to language skills.
    CONCLUSIONS: These findings may inform future interventions targeting auditory and language impairments in ASD population.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fncel.2023.1226580。].
    [This corrects the article DOI: 10.3389/fncel.2023.1226580.].
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