• 文章类型: Journal Article
    据报道,自闭症谱系障碍患者的焦虑患病率很高。这篇小型评论评估了现有的研究心率变异性生物反馈,以帮助控制自闭症谱系障碍患者的焦虑症状。对电子数据库进行了彻底搜索,以查找相关文献。与专家和图书馆员的协商有助于按照PICO框架开发搜索词。搜索了五个数据库,使用Covidence软件进行筛查,与PRISMA流程图中概述的过程。最新的审查显示了积极的短期效果,但需要长期随访。未来的调查应考虑设备类型,培训设置,和控制干预措施。独立于生物反馈设备的准确心率变异性评估至关重要。建议使用其他措施,如皮质醇评估和用户反馈,以进行全面评估。这些发现突出了证据基础的进展,并为未来的方向提供了见解。
    There is a reported high prevalence of anxiety in people with autism spectrum disorder. This mini review appraises existing research investigating heart rate variability biofeedback to help manage symptoms of anxiety in people with autism spectrum disorder. A thorough search of electronic databases was conducted to find relevant literature. Consultation with experts and a librarian helped develop search terms following the PICO framework. Five databases were searched, and screening was undertaken using Covidence software, with the process outlined in a PRISMA flowchart. The latest review showed positive short-term effects but there is a need for long-term follow-up. Future investigations should consider device type, training settings, and control interventions. Accurate heart rate variability assessment independent of biofeedback devices is crucial. Additional measures like cortisol assessment and user feedback are recommended for comprehensive evaluation. The findings highlight progress in the evidence base and offer insight to future directions.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fpsyt.2024.1287096。].
    [This corrects the article DOI: 10.3389/fpsyt.2024.1287096.].
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  • 文章类型: Journal Article
    尽管自闭症患者的记忆挑战最近被描述为特征,海马和腹侧颞叶的功能连接,对情景记忆和语义记忆功能很重要的两种结构,在自闭症患者中知之甚少。此外,与这两个记忆网络相关的功能连接与年龄相关的差异尚未揭示。
    当前的研究调查了来自开放数据集ABIDE-I的匹配良好的ASD(n=73;年龄范围:10.23-55.40岁)和非ASD组(n=74;年龄范围:10.46-56.20岁)中海马和腹侧颞叶(vTL)记忆网络内在连通性的年龄相关差异使用了理论驱动的ROI到ROI方法和基于探索性种子的全脑方法。
    我们的研究结果表明,与非ASD同行相比,ASD的连通性降低,以及与年龄相关的海马和vTL网络与三重网络的连通性降低,即,默认模式网络(DMN),中央执行网络(CEN),和显著性网络(SN),潜在的支撑他们在记忆中的挑战,语言,和社会功能。然而,我们没有观察到ASD组和非ASD组之间年龄相关效应的可靠差异.我们的研究强调了在整个生命周期中了解ASD中记忆网络功能障碍的重要性,以告知教育和临床实践。
    UNASSIGNED: Although memory challenges in autistic individuals have been characterized recently, the functional connectivity of the hippocampus and ventral temporal lobe, two structures important for episodic and semantic memory functions, are poorly understood in autistic individuals. Moreover, age-related differences in the functional connectivity associated with these two memory networks are unrevealed.
    UNASSIGNED: The current study investigated age-related differences in intrinsic connectivity of the hippocampal and ventral temporal lobe (vTL) memory networks in well-matched ASD (n = 73; age range: 10.23-55.40 years old) and Non-ASD groups (n = 74; age range: 10.46-56.20 years old) from the open dataset ABIDE-I. Both theory-driven ROI-to-ROI approach and exploratory seed-based whole-brain approach were used.
    UNASSIGNED: Our findings revealed reduced connectivity in ASD compared to Non-ASD peers, as well as an age-related reduction in the connectivity of hippocampal and vTL networks with triple networks, namely, the default mode network (DMN), the central executive network (CEN), and the salience network (SN), potentially underpinning their challenges in memory, language, and social functions. However, we did not observe reliable differences in age-related effects between the ASD and Non-ASD groups. Our study underscores the importance of understanding memory network dysfunctions in ASD across the lifespan to inform educational and clinical practices.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是一种行为定义的复杂神经发育综合征,其特征是持续的社交交流和互动缺陷。经颅磁刺激(TMS)是一种有前途的新兴工具,可通过减少核心和相关症状来干预ASD。已经发表了一些关于基于TMS的ASD治疗的综述,然而,对研究特点的系统回顾,特定的刺激参数,本地化技术,刺激目标,行为结果,自2018年以来,神经图像生物标志物的变化滞后。这里,我们对2018年后在PubMed上发表的文献进行了系统搜索,WebofScience,科学直接。筛选后,最终的系统审查包括17篇文章,组成7项随机对照试验研究和10项开放标签研究。两项研究是双盲的,而其他研究有中度到高度的偏倚风险,归因于对治疗分配的主观和评估者盲化不足.五项研究利用θ脉冲刺激模式,其他人应用低频重复TMS(五项研究),高频率(六项研究),并结合低频和高频刺激(一项研究)。大多数研究人员优先考虑双侧背外侧前额叶作为刺激目标,而顶叶小叶,下顶叶小叶,和后颞上沟也成为新的关注目标。三分之一的研究使用基于解剖磁共振成像的神经导航来定位刺激目标。TMS干预后,在一系列尺度上的明显增强在刻板的行为中很明显,重复行为,和口头社交领域。对过去五年的文献的全面回顾证明了TMS治疗ASD在改善临床核心症状方面的潜力。
    Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit. Transcranial magnetic stimulation (TMS) is a promising and emerging tool for the intervention of ASD by reducing both core and associate symptoms. Several reviews have been published regarding TMS-based ASD treatment, however, a systematic review on study characteristics, specific stimulating parameters, localization techniques, stimulated targets, behavioral outcomes, and neuroimage biomarker changes is lagged behind since 2018. Here, we performed a systematic search on literatures published after 2018 in PubMed, Web of Science, and Science Direct. After screening, the final systematic review included 17 articles, composing seven randomized controlled trial studies and ten open-label studies. Two studies are double-blind, while the other studies have a moderate to high risk of bias attributing to inadequate subject- and evaluator-blinding to treatment allocation. Five studies utilize theta-burst stimulation mode, and the others apply repetitive TMS with low frequency (five studies), high frequency (six studies), and combined low and high frequency stimulation (one study). Most researchers prioritize the bilateral dorsolateral prefrontal lobe as stimulation target, while parietal lobule, inferior parietal lobule, and posterior superior temporal sulci have also emerged as new targets of attention. One third of the studies use neuronavigation based on anatomical magnetic resonance imaging to locate the stimulation target. After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.
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  • 文章类型: Journal Article
    我们的核心前提是,生酮饮食的个性化变化可能会使患有多个领域的神经精神症状的儿科患者受益。尽管小儿癫痫目前是严格生酮饮食的公认适应症,缺乏知识,因此缺乏临床指南,可以推荐营养酮症用于广泛的儿科疾病,如自闭症谱系障碍和多动症,即使存在共病癫痫。然而,有已发表的队列研究和目前的临床试验实施医学生酮治疗认知障碍,精神病合并症,运动障碍,甚至神经炎症。作为整体实践者,我们必须全面考虑儿童的健康-当生酮饮食在治疗肥胖等神经外疾病方面可能具有协同作用时,还提供生酮饮食作为治疗选择。虽然有独特的儿科潜在不良副作用,如线性生长减速和微量营养素缺乏,以前的癫痫试验和我们中心的经验已经证明,在适当的患者监测和支持下,生酮饮食是一种低风险干预措施.
    Our core premise is that personalized variations of a ketogenic diet are likely to benefit pediatric patients with neuropsychiatric symptoms across multiple domains. Although pediatric epilepsy is currently a well-accepted indication for a strict ketogenic diet, there is a dearth of knowledge and therefore clinical guidelines upon which to recommend nutritional ketosis for pervasive pediatric conditions such as autism spectrum disorder and ADHD, even when comorbid epilepsy is present. However, there are published cohort studies and current clinical trials implementing medical ketogenic therapies for cognitive impairment, psychiatric comorbidities, motor disability, and even neuroinflammation. As holistic practitioners, it is imperative that we consider the health of a child in its entirety - and additionally offer the ketogenic diet as a therapeutic option when it may be synergistic in treating extra-neurologic diseases such as obesity. While there are uniquely pediatric potential adverse side effects such as linear growth deceleration and micronutrient deficiencies, previous trials in epilepsy and our center\'s experience have already proven the ketogenic diet to be a low-risk intervention when optimized with appropriate patient monitoring and support.
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  • 文章类型: Journal Article
    (1)背景和目标:这篇综述旨在确定有关双语对居住在希腊的自闭症谱系障碍(ASD)儿童的语言技能的可能影响的最新文献。(2)材料和方法:通过选择文章并回顾在同行评审期刊上发表的四项研究,在Scopus和PubMed的数据库中检索文献。本范围审查基于PRISMA范围审查建议的标准,而PCC框架被用作构建明确而有意义的目标和资格标准的指南。(3)结果:审查中包含的出版物涉及各种与语言相关的技能,包括形态学,语法-语用接口,叙事能力,以及接受和表达语言技能。(4)结论:四分之三的研究提供的证据表明,双语ASD儿童与单语同龄人相比并不处于不利地位,而是享受一些好处。在某种程度上,由于双语。然而,审查研究的数量以及研究本身的局限性使该结论具有暂定性。此外,这些发现为言语治疗师制定了指导方针,教育工作者,心理学家,希腊背景下的医生在治疗或教育患有ASD的双语儿童时需要遵循。
    (1) Background and Objectives: This review aims to identify the latest literature on the possible effect of bilingualism on the linguistic skills of children with autism spectrum disorder (ASD) residing in Greece. (2) Materials and Methods: The literature was searched in the databases of Scopus and PubMed by selecting articles and by reviewing four studies published in peer-reviewed journals. This Scoping Review is based on the standards of PRISMA recommendations for scoping reviews, while the PCC framework was used as a guide to construct clear and meaningful objectives and eligibility criteria. (3) Results: The publications included in the review addressed a variety of language-related skills, including morphology, the syntax-pragmatics interface, narrative ability, as well as both receptive and expressive language skills. (4) Conclusions: Three out of four studies provide evidence that bilingual ASD children are not disadvantaged compared to monolingual peers but rather enjoy some benefits, to a certain extent, due to bilingualism. However, the number of the reviewed studies as well as the limitations of the studies themselves render this conclusion tentative. Additionally, the findings set guidelines that speech therapists, educators, psychologists, and doctors in the Greek context need to follow when treating or educating bilingual children with ASD.
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  • 文章类型: Journal Article
    这项研究解决了人工色素对儿科人群的有害影响,包括被诊断为自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)的儿童,以及那些没有行为障碍的人。人们一致认为,合成食品色素对消费者有几个影响,尤其是儿科,由于它们对感官吸引力的影响,这可以鼓励人们偏爱某些食物。结果表明,这些颜色添加剂与一系列健康问题直接相关,对儿童的影响更大,包括对致癌等病理状况的易感性,过敏,诱变,细胞毒性,和碎屑活动,以及胃肠道和呼吸系统问题,除了有和没有诊断障碍的儿童的行为变化。合成染料对有或没有合并症的儿童的危害令人担忧,需要父母采取谨慎和积极的态度,照顾者和公共当局。
    This study addressed the harmful effects of artificial colors in pediatric populations, including children diagnosed with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), as well as those without behavioral disorders. There is a consensus that synthetic food colorings have several impacts on consumers, especially pediatrics, due to their influence on sensory appeal, which can encourage preference for certain foods. The results revealed that these color additives are directly linked to a series of health problems, with a greater impact on children, including a predisposition to pathological conditions such as carcinogenic, allergenic, mutagenic, cytotoxic, and clastogenic activities, as well as gastrointestinal and respiratory problems, in addition to behavioral changes in children with and without diagnosed disorders. The harms of synthetic dyes in children with or without comorbidities are worrying and require a careful and proactive approach from parents, caregivers and public authorities.
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  • 文章类型: Journal Article
    背景:除了其状况的固有挑战外,自闭症谱系障碍(ASD)儿童也容易受到全球肥胖流行的影响。然而,关于摩洛哥ASD儿科人群中肥胖的患病率,数据仍然稀缺。
    方法:共有258名年龄在6至12岁(平均=9.4±1.4)被诊断为ASD的儿童(男孩=195)参加了这项研究。除了体重和身高,检查了用于评估肥胖的四个重要的人体测量指标:体重指数(BMI),体表面积(BSA),腰围(WC),和腰围高度比(WHtR)。根据Z评分及其相应的百分位数,将每个人体测量标记分为三个心脏代谢风险水平之一。分布如下:低风险(≤84百分位数),高风险(第85-94百分位数),和非常高的风险(≥95百分位数)。随后,采用多元回归分析来开发生成复合风险评分的算法.这个分数同时包含了所有的人体测量变量,同时还加权他们对心脏代谢风险的个人贡献。
    结果:患有ASD的儿童表现出的人体测量特征显著增加了他们对心脏代谢问题的易感性。虽然大约11%的摩洛哥儿童人口超重或肥胖,在ASD患儿中,这一数字飙升至近60%,考虑到中心肥胖指标.此外,与具有较低社会经济背景的儿童相比,具有中产阶级社会经济背景的儿童出现超重或肥胖的风险高出三倍以上.
    结论:这项研究有,第一次,提供了使用传统人体测量法对摩洛哥ASD儿童的心脏代谢风险的最新概述。主要危险因素显然与中心(腹部)肥胖有关,这被认为是最有害的。这项研究强调了纳入一般和中心性肥胖标志物的必要性。这项研究强调了纳入一般和中心肥胖指标以进行更全面评估的重要性。它强调需要在这一高风险人群中进行更密切的监测。
    BACKGROUND: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce.
    METHODS: A total of 258 children (boys = 195) aged 6 to 12 years old (mean = 9.4 ± 1.4) diagnosed with ASD participated in this study. Besides the body mass and height, four significant anthropometric markers for assessing obesity were examined: body mass index (BMI), body surface area (BSA), waist circumference (WC), and waist-to-height ratio (WHtR). Each anthropometric marker was categorized into one of three cardiometabolic risk levels based on the Z-scores and their corresponding percentiles. The distribution was as follows: low risk (≤84th percentile), high risk (85th-94th percentile), and very high risk (≥95th percentile). Subsequently, a multiple regression analysis was employed to develop an algorithm that generates a composite risk score. This score incorporates all the anthropometric variables simultaneously, while also weighting their individual contributions to the cardiometabolic risk.
    RESULTS: Children with ASD exhibit an anthropometric profile that markedly increases their susceptibility to cardiometabolic issues. While roughly 11% of the general Moroccan child population is overweight or obese, this figure soars to nearly 60% among children with ASD when considering the central adiposity markers. Furthermore, children from middle-class socioeconomic backgrounds display a more than threefold greater risk of developing overweight or obesity compared to their counterparts from lower socioeconomic backgrounds.
    CONCLUSIONS: This study has, for the first time, provided an up-to-date overview of the cardiometabolic risk in Moroccan children with ASD using traditional anthropometric measurements. The primary risk factor is clearly linked to central (abdominal) adiposity, which is recognized as the most deleterious. This study highlights the need to include general and central obesity markers. This study underscores the importance of incorporating both general and central adiposity markers for a more comprehensive assessment, and it emphasizes the need for closer monitoring within this high-risk population.
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  • 文章类型: Journal Article
    背景:自闭症谱系障碍(ASD)是一种神经发育障碍,其特征是社交互动受损以及限制性和重复性行为。氧化应激可能是线粒体功能障碍与ASD之间的关键联系,因为由促氧化环境毒物和激活的免疫细胞产生的活性氧(ROS)可导致线粒体衰竭。最近,线粒体功能障碍,自身免疫,在多项研究中,异常脂质介质已被确定为ASD的公认病因机制,可作为治疗干预的目标。
    方法:与炎症诱导相关的脂质介质标志物之间的关系,如磷脂酶A2/环氧合酶-2(PLA2/Cox-2),和线粒体功能障碍标记抗线粒体抗体(AMA-M2),在这项研究中,使用组合的受试者工作特征(ROC)曲线分析研究了ASD病因中的抗组蛋白自身抗体。该研究还试图鉴定一组给定标记的线性组合,其优化ROC曲线下的部分面积。这项研究包括40名年龄和性别匹配的对照和40名ASD青少年。使用ELISA试剂盒检测两组血浆的PLA2/COX-2、AMA-M2和抗组蛋白自身抗体水平。采用ROC曲线和logistic回归模型进行统计分析。
    结果:使用综合ROC曲线分析,曲线下的面积显着上升。此外,联合标记物的特异性和敏感性明显提高.
    结论:当前的研究表明,测量与线粒体功能障碍相关的选定生物标志物的预测价值,自身免疫,使用ROC曲线分析ASD儿童的脂质代谢可以更好地了解ASD的病因机制及其与代谢的关系。
    BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and restricted and repetitive behaviors. Oxidative stress may be a critical link between mitochondrial dysfunction and ASD as reactive oxygen species (ROS) generated from pro-oxidant environmental toxicants and activated immune cells can result in mitochondrial failure. Recently, mitochondrial dysfunction, autoimmunity, and abnormal lipid mediators have been identified in multiple investigations as an acknowledged etiological mechanism of ASD that can be targeted for therapeutic intervention.
    METHODS: The relationship between lipid mediator markers linked to inflammation induction, such as phospholipase A2/cyclooxygenase-2 (PLA2/Cox-2), and the mitochondrial dysfunction marker anti-mitochondrial antibodies (AMA-M2), and anti-histone autoantibodies in the etiology of ASD was investigated in this study using combined receiver operating characteristic (ROC) curve analyses. This study also sought to identify the linear combination for a given set of markers that optimizes the partial area under ROC curves. This study included 40 age- and sex-matched controls and 40 ASD youngsters. The plasma of both groups was tested for PLA2/COX-2, AMA-M2, and anti-histone autoantibodies\' levels using ELISA kits. ROC curves and logistic regression models were used in the statistical analysis.
    RESULTS: Using the integrated ROC curve analysis, a notable rise in the area under the curve was noticed. Additionally, the combined markers had markedly improved specificity and sensitivity.
    CONCLUSIONS: The current study suggested that measuring the predictive value of selected biomarkers related to mitochondrial dysfunction, autoimmunity, and lipid metabolism in children with ASD using a ROC curve analysis could lead to a better understanding of the etiological mechanism of ASD as well as its relationship with metabolism.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)和注意力缺陷/多动障碍(ADHD)的患病率正在增加,有共同发生的趋势。一些研究表明,非典型的感觉处理和执行功能之间存在联系。本研究旨在通过探讨感觉加工与执行功能的关系,探讨ASD+ADHD儿童执行功能缺陷的独特病因。将儿童与ASD进行比较,ASD+多动症,多动症,通常是发育中的儿童(TD)。
    方法:在120名学龄儿童中测量了感官概况2(SP-2)和行为评估量表2(BRIEF-2)。以上量表的结果在这四组中进行了比较,并对BRIEF2和SP2进行了相关和回归分析。
    结果:我们的研究显示,与TD组相比,三个神经发育障碍组的非典型感觉加工和执行功能异常水平不同。ASD+ADHD组表现出特别显著的差异。在ASDADHD儿童中观察到的情绪问题加剧可能与更突出的非典型感觉处理有关。抑制功能的方差分析显示ASD+ADHD和ADHD儿童之间存在差异,提示ASD+ADHD和ADHD之间注意力问题的不同病因机制。
    结论:ASD+ADHD代表一种不同于ASD和ADHD的表型。应特别考虑对ASD+ADHD儿童的干预措施。这项研究的结果可能为理解ASDADHD的发生和潜在的个性化干预方法提供新的视角。
    The prevalence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) is increasing, with a tendency for co-occurrence. Some studies indicate a connection between atypical sensory processing and executive function. This study aims to explore the distinctive etiology of executive function deficits in children with ASD+ADHD by investigating the relationship between sensory processing and executive function, comparing children with ASD, ASD+ADHD, ADHD, and typically developing children (TD).
    METHODS: Sensory Profile 2 (SP-2) and Behavior Rating Inventory of Executive Function 2 (BRIEF-2) were measured in 120 school-aged children. The results of the above scales were compared across these four groups, and correlation and regression analyses between BRIEF2 and SP2 were conducted.
    RESULTS: Our research revealed varying levels of atypical sensory processing and executive function anomalies across the three neurodevelopmental disorder groups compared to the TD group. The ASD+ADHD group showed particularly significant differences. The heightened emotional problems observed in ASD+ADHD children may be associated with more prominent atypical sensory processing. Variance analysis of inhibitory function revealed differences between ASD+ADHD and ADHD children, suggesting distinct etiological mechanisms for attention issues between ASD+ADHD and ADHD.
    CONCLUSIONS: ASD+ADHD represents a phenotype distinct from both ASD and ADHD. Special consideration should be given to interventions for children with ASD+ADHD. The results of this study may offer a new perspective on understanding the occurrence of ASD+ADHD and potential individualized intervention methods.
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