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PubMed2003

[Savant or idiot savant syndrome].

Savant syndrome is currently still very mysterious, yet, thanks to the progress made in neuroimaging studies and especially MSI (Magnetic Source Imaging) techniques, a little more is now known about it. The theory, formulated many years ago, about damage to the left hemisphere of the brain has been supported by functional neuroimaging. Its relation to developmental disorders or to autism spectrum disorders is far more justified today and can be explained on the basis of its neuropathology. We present a study based on a review of the scientific literature concerning the syndrome, from the first time it was described back in 1789 by Benjamin Rush up to the present day. We comment on its epidemiology and positive clinical manifestations, involving brilliant artistic talent and dazzling memory, but also the negative aspects suffered by these autistic patients. The most important theories are discussed together with the clinical coincidence with frontotemporal dementia and the responsibility of the right hemisphere when there are alterations in the contralateral hemisphere. The latest contributions made by Positron Emission Tomography and magnetoencephalography will be discussed and a mini-video of a personal case will be projected.

Art↗

PubMed2006

Consonant production patterns of young severely language-delayed children with autism.

UNLABELLED: While much attention has been given to documenting the language skills of verbal children with autism, the basic speech sound development patterns of severely language-impaired children with autism are unknown. Previous research has shown that certain consonants are generally produced earlier in development than other consonants, both in typically developing children and in children with language-learning impairments. While several large studies indicate that children with autism who have strong verbal skills have intact phonological development, there is some evidence that children with autism who are more severely language impaired may have abnormal phonological production. This study documents the speech sound development of non-verbal and minimally verbal children with autism. Prompts were administered for each individual speech sound while spontaneous and imitated sounds were recorded and scored. Results indicate that children with autism show the same general speech sound production patterns as typically developing and language-learning impaired children. LEARNING OUTCOMES: Individuals who read this manuscript will obtain information regarding: (1) normal phonological development, (2) a comparison of speech sound production of a group of 14 children with a diagnosis of autism spectrum disorder with the production of a group of 10 typically developing children, and (3) comparisons of imitated and spontaneous sound production of the children diagnosed with autism spectrum disorder.

Autistic Disorder↗

PubMed2006

Genetic heterogeneity between the three components of the autism spectrum: a twin study.

OBJECTIVE: This study investigated the etiology of autistic-like traits in the general population and the etiological overlap between the three aspects of the triad of impairments (social impairments, communication impairments, restricted repetitive behaviors and interests) that together define autism spectrum disorders. METHOD: Parents of 3,400 8-year-old twin pairs from the Twins Early Development Study completed the Childhood Asperger Syndrome Test, a screening instrument for autism spectrum symptoms in mainstream samples. Genetic model-fitting of categorical and continuous data is reported. RESULTS: High heritability was found for extreme autistic-like traits (0.64-0.92 for various cutoffs) and autistic-like traits as measured on a continuum (0.78-0.81), with no significant shared environmental influences. All three subscales were highly heritable but showed low covariation. In the genetic modeling, distinct genetic influences were identified for the three components. CONCLUSIONS: These results suggest the triad of impairments that define autism spectrum disorders is heterogeneous genetically. Molecular genetic research examining the three components separately may identify different causal pathways for the three components. The analyses give no indication that different genetic processes affect extreme autistic impairments and autistic impairments as measured on a continuum, but this can only be directly tested once genes are identified.

Asperger Syndrome↗

PubMed2006

Recent advances in the genetics of autism.

Autism is a strongly genetic disorder, with an estimated heritability of greater than 90%. Nonetheless, its specific genetic etiology remains largely unknown. Over the past several years, the convergence of rapidly advancing genomic technologies, the completion of the human genome project, and successful collaborative efforts to increase the number of deoxyribonucleic acid samples available for study have led to the first solid clues regarding the genetic origins of autism spectrum disorders. This article addresses the obstacles that have confronted gene discovery efforts and reviews recent linkage, cytogenetic, and candidate gene association studies relevant to autism spectrum disorders. In addition, promising avenues for future research and the potential contribution of emerging genomic technologies are considered.

Autistic Disorder↗

PubMed2003

Epidemiology and early identification of autism: research challenges and opportunities.

Recent studies suggest that the prevalence of autism spectrum disorders may be as high as 60 per 10000, considerably greater than the long-accepted figure of 5 per 10 000 for classic autism. Increased recognition, the broadening of the diagnostic concept and methodological differences across studies may account for most or all of the apparent increase in prevalence, although this cannot be quantified. In addition to the implications for families and services, these conceptual changes will affect the scientific study of autism. At present, case definition is reliant on the behavioural and developmental picture alone. Because the behavioural phenotype of autism and the broader autism spectrum disorders includes individuals with different ultimate aetiologies, even when biological or genetic markers are found they will not be present in all individuals with the phenotype. The fact that autism is not a unitary 'disorder' presents a significant challenge to genetic, biological, neurological and psychological research. Progress has recently been made in the earlier identification of autism both through screening programmes and by increased understanding and enhanced surveillance. This offers an opportunity to better understand the early developmental course of autism and may provide additional clues to the underlying pathology.

Autistic Disorder↗

PubMed2004

Perinatal factors and the development of autism: a population study.

BACKGROUND: Autism is considered to have a genetic basis, although exposure to certain stimuli in the prenatal period has been implicated to be causal in some cases. Some investigations have shown an association with obstetric complications but findings have been inconsistent owing to differences in sampling and methods. OBJECTIVE: To examine the association of obstetric factors with autism spectrum disorders for a cohort of children, using obstetric data contained in a statutory database collected at the time of birth. DESIGN: Subjects born in Western Australia between 1980 and 1995 and diagnosed with an autism spectrum disorder by 1999 were included as cases (n = 465). Siblings of the cases (n = 481) and a random population-based control group (n = 1313) were compared with the cases on obstetric information contained in the Maternal and Child Health Research Database of Western Australia. RESULTS: Compared with control subjects, cases had significantly older parents and were more likely to be firstborn. Case mothers had greater frequencies of threatened abortion, epidural caudal anesthesia use, labor induction, and a labor duration of less than 1 hour. Cases were more likely to have experienced fetal distress, been delivered by an elective or emergency cesarean section, and had an Apgar score of less than 6 at 1 minute. Cases with a diagnosis of autism had more complications than those with pervasive developmental disorder not otherwise specified or Asperger syndrome. Nonaffected siblings of cases were more similar to cases than control subjects in their profile of complications. CONCLUSIONS: Autism is unlikely to be caused by a single obstetric factor. The increased prevalence of obstetric complications among autism cases is most likely due to the underlying genetic factors or an interaction of these factors with the environment.

Anesthesia, Epidural↗

PubMed2005

[Educational intervention in autism from a psychological point of view].

INTRODUCTION: Autism is the prototypical condition in autism spectrum disorders. It is a developmental disorder of biological origin that becomes apparent by the age of 3 and which is characterised by qualitative alterations affecting the development of social relations and interaction, communication and language, and the development of symbolic and imaginative activity. DEVELOPMENT: The first manifestations of the disorder take place, in most cases and according to the two sources of information currently available (retrospective information provided by the families and the analysis of family videos), around the end of the first year (the age of 18 months is one of the ages most frequently mentioned by the families when asked about the matter). From an ontogenetic point of view, the coincidence between the times of the first manifestations of the disorder and the development of qualitatively human psychological functions is significant. Autism can, therefore, be understood to be a disorder that affects the genesis of psychological factors that are extremely relevant to human development and, thus, educational intervention must necessarily include the construction of these psychological functions as far as this is possible. CONCLUSIONS: Educational treatment in autism and in autism spectrum disorders have to be based on two essential areas of knowledge that must guide the implementation of any intervention programme, i.e. developmental and ontogenetic knowledge of typical development and knowledge of the autistic way of 'being'. The essential part of the treatment carried out in autism lies in the flexible and creative integration of our knowledge in these two areas.

Autistic Disorder↗

PubMed2002

Pregnancy and birth complications in autism and liability to the broader autism phenotype.

OBJECTIVE: To understand better the relationship between pregnancy and birth complications and genetic factors in autism. METHOD: The sample included 78 children with an autism spectrum disorder and 88 unaffected siblings. A standardized interview was used to ask mothers about the pregnancy and birth of each child, and an overall index reflecting freedom from complications (termed "optimality") was determined. The presence of autism-like traits (termed the "broader autism phenotype") in second- and third-degree relatives was ascertained by reports from multiple informants. The pro-. portion of relatives with the broader autism phenotype, corrected for degree of relation, was used as an index of family loading. RESULTS: Children with autism spectrum disorders have lower optimality (higher rates of complications) than unaffected siblings. High family loading for the broader autism phenotype is associated with higher rates of complications in unaffected siblings. Family loading was not significantly associated with complications in affected siblings in this sample. Overall, these findings argue against complications being a direct cause of autism, as one would expect to find the most complications in sporadic cases (i.e., in children without a positive family history). CONCLUSION: Increased rates of birth and pregnancy complications are likely secondary to familial factors associated with autism.

Autistic Disorder↗

PubMed2007

Autism spectrum phenotype in males and females with fragile X full mutation and premutation.

The behavioural phenotype of autism was assessed in individuals with full mutation and premutation fragile X syndrome (FXS) using the Autism Diagnostic Observation Scale-Generic (ADOS-G) and the Autism Diagnostic Interview (ADI-R). The participants, aged 5-80 years, comprised 33 males and 31 females with full mutation, 7 males and 43 females with premutation, and 38 non-fragile X relatives (29 males, 9 females). In the full mutation group, a total of 67% males and 23% females met either the Autism Disorder (AD) or the Autism Spectrum Disorder (ASD) criteria on at least one of the diagnostic tests. In the premutation group, 14% males and 5% females met the ADOS-G criteria for ASD. The presence of autism manifestations in males and females with full mutation and premutation provide support for a spectrum view.

Activities of Daily Living↗

PubMed2024

Sex differences in MAGEL2 gene promoter methylation in high functioning autism - trends from a pilot study using nanopore Cas9 targeted long read sequencing.

BACKGROUND: MAGEL2 is an autism susceptibility gene whose deficiency has been associated with autism-related behaviors in animal models and in syndromic human autism spectrum disorders (ASDs) such as Schaaf-Yang syndrome, but has not been studied in the broader autism spectrum. Given the capabilities of long-read sequencing technologies, this pilot study used a targeted nanopore sequencing approach to simultaneously examine MAGEL2 DNA sequence and methylation in adults with high-functioning autism (HFA) compared to neurotypical controls (NC). METHODS: Using DNA extracted from peripheral blood, Cas9-targeted nanopore DNA sequencing was used to analyze MAGEL2, including its entire regulatory construct (chr15:23639316-23651466), for sequence variation and 5-methyl-cytosine (5mC) modification in a cohort of adults with HFA compared to sex- and age-matched NC. Given the known sex differences in ASD and MAGEL2 KO animal models, results were further analyzed by sex. RESULTS: 20 adults with HFA (10 males, 10 females) and 20 NC were included. While there were no overall differences in MAGEL2 DNA sequence and 5mC modification between HFA and NC, we found a significant difference in MAGEL2 gene promoter methylation between males and females with HFA and NC of both sexes, with HFA males tending to show hypomethylation in a 300 bp long differentially methylated region (chr15:23647640-23647939) around the MAGEL2 transcription start site. CONCLUSIONS: In this pilot study utilizing nanopore Cas9 targeted DNA sequencing, significant sex-specific differences in MAGEL2 gene promoter methylation were identified in male adults with HFA in comparison to control groups, suggesting the potential for sex-specific epigenetic differences. However, further replication in larger cohorts is required to validate these findings.

Humans↗

PubMed2025

Cell-type-specific dysregulation of gene expression due to Chd8 haploinsufficiency during mouse cortical development.

Disruptive variants in the chromodomain helicase CHD8 are associated with risk for autism spectrum disorder (ASD). CHD8 haploinsufficiency is hypothesized to contribute to ASD by perturbing neurodevelopmental gene expression. However, insight into cell-type-specific transcriptional effects of CHD8 haploinsufficiency remains limited. We used single-cell and single-nucleus RNA sequencing to identify dysregulated genes in the embryonic and juvenile Chd8+/- mouse cortex. Chd8 and other ASD risk-associated genes showed a convergent expression trajectory conserved between mouse and human developing cortex, increasing from progenitor zones to the cortical plate. Genes associated with neurodevelopmental disorders or involved in chromatin remodeling and neuron projection development were dysregulated in Chd8+/- embryonic radial glia. Genes implicated in synaptic activity and organization were dysregulated in Chd8+/- postnatal excitatory cortical neurons, suggesting impaired synaptogenesis. Our findings reveal complex patterns of transcriptional dysregulation due to Chd8 haploinsufficiency, potentially with distinct impacts on progenitors and maturing neurons in the excitatory neuronal lineage.

Animals↗

PubMed2007

Disembedding performance in children and adolescents with Asperger syndrome or high-functioning autism.

The aim of the present study was to assess the findings, reported in earlier studies, that individuals with autism spectrum disorders process visuo-spatial tasks faster than typically developing control persons. The participants in the present study were children and adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) (N = 13), and a matched group of typically developing children and adolescents (N = 13). The results showed that the participants in the clinical group performed marginally less well than those in the control group on both the Block Design Test and the Embedded Figures Test, but the differences were not statistically significant. Thus, earlier findings suggesting that individuals with autism spectrum disorders solve non-social cognitive tasks faster than typically developing control persons were not replicated. The results are discussed with special reference to the hypothesis of weak central coherence.

Adolescent↗

PubMedDate not supplied

Autism associated with conditions characterized by developmental errors in early embryogenesis: a mini review.

Autism is a complex developmental disorder without an established single etiology but with significant contributions from genetic studies, functional research, and neuropsychiatric and neuroradiologic investigations. The purpose of this paper is to review the findings in five studies involving individuals manifesting the characteristic findings of autism spectrum disorder associated with malformations and dysfunctions known to result from early embryogenic defects. These investigations include two associated with teratogens (thalidomide embryopathy, Mobius sequence with misoprostol) and three (most Mobius sequence cases, CHARGE association, Goldenhar syndrome) with no known etiology. These studies suggest that early embryonic development errors often involving cranial nerve palsies, internal and external ear malformations, ophthalmologic anomalies, and a variety of systemic malformations may be associated with autism spectrum disorders statistically more frequently than expected in a normal population. Although the exact time of developmental insult for each condition cannot be identified, the evidence is that it may occur as early as week 4 to 6+ of embryogenesis.

Abnormalities, Multiple↗

PubMed2003

Autistic traits in the general population: a twin study.

BACKGROUND: Recent research has indicated that autism is not a discrete disorder and that family members of autistic probands have an increased likelihood of exhibiting autistic symptoms with a wide range of severity, often below the threshold for a diagnosis of an autism spectrum disorder. OBJECTIVE: To examine the distribution and genetic structure of autistic traits in the general population using a newly established quantitative measure of autistic traits, the Social Responsiveness Scale (formerly known as the Social Reciprocity Scale). METHODS: The sample consisted of 788 pairs of twins aged 7 to 15 years, randomly selected from the pool of participants in a large epidemiologic study (the Missouri Twin Study). One parent of each pair of twins completed the Social Responsiveness Scale on each child. The data were subjected to structural equation modeling. RESULTS: Autistic traits as measured by the Social Responsiveness Scale were continuously distributed and moderately to highly heritable. Levels of severity of autistic traits at or above the previously published mean for patients with pervasive developmental disorder not otherwise specified were found in 1.4% of boys and 0.3% of girls. Structural equation modeling revealed no evidence for the existence of sex-specific genetic influences, and suggested specific mechanisms by which females may be relatively protected from vulnerability to autistic traits. CONCLUSIONS: These data indicate that the social deficits characteristic of autism spectrum disorders are common. Given the continuous distribution of these traits, it may be arbitrary where cutoffs are made between research designations of being "affected" vs "unaffected" with a pervasive developmental disorder. The genes influencing autistic traits appear to be the same for boys and girls. Lower prevalence (and severity) of autistic traits in girls may be the result of increased sensitivity to early environmental influences that operate to promote social competency.

Adolescent↗

PubMed2006

Oxytocin, vasopressin and pair bonding: implications for autism.

Understanding the neurobiological substrates regulating normal social behaviours may provide valuable insights in human behaviour, including developmental disorders such as autism that are characterized by pervasive deficits in social behaviour. Here, we review the literature which suggests that the neuropeptides oxytocin and vasopressin play critical roles in modulating social behaviours, with a focus on their role in the regulation of social bonding in monogamous rodents. Oxytocin and vasopressin contribute to a wide variety of social behaviours, including social recognition, communication, parental care, territorial aggression and social bonding. The effects of these two neuropeptides are species-specific and depend on species-specific receptor distributions in the brain. Comparative studies in voles with divergent social structures have revealed some of the neural and genetic mechanisms of social-bonding behaviour. Prairie voles are socially monogamous; males and females form long-term pair bonds, establish a nest site and rear their offspring together. In contrast, montane and meadow voles do not form a bond with a mate and only the females take part in rearing the young. Species differences in the density of receptors for oxytocin and vasopressin in ventral forebrain reward circuitry differentially reinforce social-bonding behaviour in the two species. High levels of oxytocin receptor (OTR) in the nucleus accumbens and high levels of vasopressin 1a receptor (V1aR) in the ventral pallidum contribute to monogamous social structure in the prairie vole. While little is known about the genetic factors contributing to species-differences in OTR distribution, the species-specific distribution pattern of the V1aR is determined in part by a species-specific repetitive element, or 'microsatellite', in the 5' regulatory region of the gene encoding V1aR (avpr1a). This microsatellite is highly expanded in the prairie vole (as well as the monogamous pine vole) compared to a very short version in the promiscuous montane and meadow voles. These species differences in microsatellite sequence are sufficient to change gene expression in cell culture. Within the prairie vole species, intraspecific variation in the microsatellite also modulates gene expression in vitro as well as receptor distribution patterns in vivo and influences the probability of social approach and bonding behaviour. Similar genetic variation in the human AVPR1A may contribute to variations in human social behaviour, including extremes outside the normal range of behaviour and those found in autism spectrum disorders. In sum, comparative studies in pair-bonding rodents have revealed neural and genetic mechanisms contributing to social-bonding behaviour. These studies have generated testable hypotheses regarding the motivational systems and underlying molecular neurobiology involved in social engagement and social bond formation that may have important implications for the core social deficits characterizing autism spectrum disorders.

Animals↗

PubMed2003

Two children with muscular dystrophies ascertained due to referral for diagnosis of autism.

We report two children who were referred for diagnostic assessment for autism and were subsequently determined to have a muscular dystrophy (MD). Each child had a history of speech delay and social impairments, but also had motor delays that had not previously been investigated. Both children met diagnostic criteria for autism spectrum disorders on standardized assessment. Each child was hypotonic and had other mild motor impairments. Serum creatine kinase (CK) activity was markedly elevated in each child, and subsequent muscle biopsy led to diagnosis of Becker's MD and congenital (autosomal recessive) MD, respectively. These cases highlight the importance of a thorough neuromotor examination for all children with suspected autism spectrum disorders.

Autistic Disorder↗

PubMed2004

Disorder-associated mutations lead to functional inactivation of neuroligins.

Autism is a neuro-developmental syndrome that affects 0.1-0.5% of the population. It has been proposed that alterations in neuronal circuitry and/or neuronal signaling are responsible for the behavioral and cognitive aberrations in autism patients. However, the cellular basis of such alterations is unknown. Recently, point mutations in a family of neuronal cell adhesion molecules called neuroligins have been linked to autism-spectrum disorders and mental retardation. We investigated the consequences of these disease-associated mutations on neuroligin function. We demonstrate that the point mutation at arginine 451 and a nonsense mutation at aspartate 396 of neuroligin-3 and -4 (NL3 and NL4), respectively, result in intracellular retention of the mutant proteins. Over-expression of wild-type NL3 and NL4 proteins in hippocampal neurons stimulates the formation of presynaptic terminals, whereas the disease-associated mutations result in a loss of this synaptic function. Our findings suggest that the previously identified mutations in neuroligin genes are likely to be relevant for the neuro-developmental defects in autism-spectrum disorders and mental retardation since they impair the function of a synaptic cell adhesion molecule.

Animals↗

PubMed2005

Variation in early developmental course in autism and its relation with behavioral outcome at 3-4 years of age.

The aims of the present study were to describe variations in the early course of development in autism by utilizing an in-depth parent interview that incorporated techniques to improve accuracy of parent recall, and to examine the relation between variations in early developmental course in autism and behavioral outcome at 3-4 years of age. The Early Development Interview, which consisted of questions about child's behavior in several domains from birth through 2 years of age, was created and administered to parents of 72 3-4-year-old children with autism spectrum disorder and 34 3-4-year-old children with developmental delay, who were matched on mental and chronological age, and 39 1-4-year-old typically developing children, who were matched to the clinical groups on mental age. At 3-4 years of age, children were administered standardized measures (some clinician administered and some parent report); these included verbal and nonverbal IQ, autism symptom severity, and adaptive and aberrant behavior. Based on the Early Development Interview, children with autism spectrum disorder (ASD) were reported to have elevated symptoms in the social and regulatory domains by 3-6 months. By 12-15 months, parents of children with ASD reported significantly higher levels of social symptoms than parents of children with developmental delay. At 3-4 years of age, children with autism with early vs. late onset of symptoms, and with vs. without a history of loss of skills (regression) were not found to differ on standardized tests of verbal and nonverbal IQ and observational measures of autism symptom severity.

Age Factors↗