Browsing by Subject "Autism spectrum disorders"

Now showing 1 - 5 of 5
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    A randomized double-blind, placebo-controlled pilot trial of mirtazapine for anxiety in children and adolescents with autism spectrum disorder
    (Springer Nature, 2022) McDougle, Christopher J.; Thom, Robyn P.; Ravichandran, Caitlin T.; Palumbo, Michelle L.; Politte, Laura C.; Mullett, Jennifer E.; Keary, Christopher J.; Erickson, Craig A.; Stigler, Kimberly A.; Mathieu-Frasier, Lauren; Posey, David J.; Psychiatry, School of Medicine
    This study was a 10-week double-blind, placebo-controlled pilot trial of mirtazapine for anxiety in youth with autism spectrum disorder (ASD). Participants were ages 5 to 17 years with ASD and clinically significant anxiety (Pediatric Anxiety Rating Scale [PARS] score ≥10). Thirty participants were randomized to mirtazapine (7.5-45 mg/day) or placebo in a 2:1 ratio. The co-primary outcome measures were the PARS and the Clinical Global Impressions-Improvement subscale (CGI-I). Mirtazapine resulted in a statistically significant within group decrease in anxiety on the PARS (ES 1.76, p < 0.001). The improvement in PARS score for mirtazapine versus placebo was clinically meaningful but not statistically significant (ES = 0.63, p = 0.64). Forty-seven percent of participants assigned to mirtazapine (95% CI 22%: 74%) and 20% assigned to placebo (95% CI 2%: 60%) were rated "much improved" (CGI-I = 2) or "very much improved" (CGI-I = 1) for anxiety, p = 0.46. No statistically significant differences in mean 10-week changes between mirtazapine and placebo occurred on any outcome measure. There were no statistically significant differences in adverse effect frequency between mirtazapine and placebo. The results are consistent with mirtazapine's safety and tolerability and meet three of four pre-specified indicators of efficacy (statistically significant change in total PARS score for mirtazapine, numerically greater reduction in total PARS score for mirtazapine than placebo, numerically higher number of responders to mirtazapine than placebo, but not greater than 50% of participants receiving mirtazapine rated as responders). Implementation of a larger randomized controlled trial of mirtazapine for the treatment of anxiety in this population is supported.
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    Autism Spectrum Disorders: Wading through the controversies on the web
    (Taylor & Francis, 2009) Coates, Heather L.
    Autism is one of three developmental disorders in the group known as the autism spectrum disorders (ASDs). This spectrum of disorders has an estimated prevalence of one in 150 children. Increased awareness and diagnosis has led to an explosion of information available about the disorder. This explosion has made scientific research more readily available, along with inaccurate and spurious information. Autism is a disorder without a known cause or cure and few treatments with sufficient evidence to indicate effectiveness. Due to the variable presentation of autism, there is no single intervention that is effective for all individuals. The complexity of the disorder is addressed by research and practice across several disciplines, including education, psychology, psychiatry, neurology, genetics, and internal medicine. This resource guide will introduce the range of autism spectrum disorders, its various perspectives and treatments, and will point librarians and patrons to introductory resources to provide links for further learning.
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    A Biomarker Characterizing Neurodevelopment with applications in Autism
    (Nature Publishing Group, 2018-01-12) Wu, Di; José, Jorge V.; Nurnberger, John I., Jr.; Torres, Elizabeth B.; Medicine, School of Medicine
    Despite great advances in neuroscience and genetic studies, our understanding of neurodevelopmental disorders is still quite limited. An important reason is not having objective psychiatric clinical tests. Here we propose a quantitative neurodevelopment assessment by studying natural movement outputs. Movement is central to behaviors: It involves complex coordination, temporal alterations, and precise dynamic controls. We carefully analyzed the continuous movement output data, collected with high definition electromagnetic sensors at millisecond time scales. We unraveled new metrics containing striking physiological information that was unseen neither by using traditional motion assessments nor by naked eye observations. Our putative biomarker leads to precise individualized classifications. It illustrates clear differences between Autism Spectrum Disorder (ASD) subjects from mature typical developing (TD) individuals. It provides an ASD complementary quantitative classification, which closely agrees with the clinicaly assessed functioning levels in the spectrum. It also illustrates TD potential age-related neurodevelopmental trajectories. Applying our movement biomarker to the parents of the ASD individuals studied in the cohort also shows a novel potential familial signature ASD tie. This paper proposes a putative behavioral biomarker to characterize the level of neurodevelopment with high predicting power, as illustrated in ASD subjects as an example.
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    Multi-level analysis of the gut–brain axis shows autism spectrum disorder-associated molecular and microbial profiles
    (Springer Nature, 2023) Morton, James T.; Jin, Dong-Min; Mills, Robert H.; Shao, Yan; Rahman, Gibraan; McDonald, Daniel; Zhu, Qiyun; Balaban, Metin; Jiang, Yueyu; Cantrell, Kalen; Gonzalez, Antonio; Carmel, Julie; Frankiensztajn, Linoy Mia; Martin-Brevet, Sandra; Berding, Kirsten; Needham, Brittany D.; Zurita, María Fernanda; David, Maude; Averina, Olga V.; Kovtun, Alexey S.; Noto, Antonio; Mussap, Michele; Wang, Mingbang; Frank, Daniel N.; Li, Ellen; Zhou, Wenhao; Fanos, Vassilios; Danilenko, Valery N.; Wall, Dennis P.; Cárdenas, Paúl; Baldeón, Manuel E.; Jacquemont, Sébastien; Koren, Omry; Elliott, Evan; Xavier, Ramnik J.; Mazmanian, Sarkis K.; Knight, Rob; Gilbert, Jack A.; Donovan, Sharon M.; Lawley, Trevor D.; Carpenter, Bob; Bonneau, Richard; Taroncher-Oldenburg, Gaspar; Anatomy, Cell Biology and Physiology, School of Medicine
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by heterogeneous cognitive, behavioral and communication impairments. Disruption of the gut–brain axis (GBA) has been implicated in ASD although with limited reproducibility across studies. In this study, we developed a Bayesian differential ranking algorithm to identify ASD-associated molecular and taxa profiles across 10 cross-sectional microbiome datasets and 15 other datasets, including dietary patterns, metabolomics, cytokine profiles and human brain gene expression profiles. We found a functional architecture along the GBA that correlates with heterogeneity of ASD phenotypes, and it is characterized by ASD-associated amino acid, carbohydrate and lipid profiles predominantly encoded by microbial species in the genera Prevotella, Bifidobacterium, Desulfovibrio and Bacteroides and correlates with brain gene expression changes, restrictive dietary patterns and pro-inflammatory cytokine profiles. The functional architecture revealed in age-matched and sex-matched cohorts is not present in sibling-matched cohorts. We also show a strong association between temporal changes in microbiome composition and ASD phenotypes. In summary, we propose a framework to leverage multi-omic datasets from well-defined cohorts and investigate how the GBA influences ASD.
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    Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome
    (Sage, 2023) McNally Keehn, Rebecca; Enneking, Brett; Ryan, Tybytha; James, Cristina; Tang, Qing; Blewitt, Audra; Tomlin, Angela; Corona, Laura; Wagner, Liliana; Pediatrics, School of Medicine
    The diagnosis of autism spectrum disorder (ASD) has traditionally been made through in-person evaluation. While the COVID-19 pandemic disrupted access to ASD services, there has been remarkable growth in research focused on novel ASD diagnostic practices, including the use of telemedicine. We implemented a standard ASD tele-assessment evaluation procedure, including use of a novel remote clinician-coached, caregiver-delivered ASD assessment tool (TELE-ASD-PEDS; TAP), with the goal of continuing to provide diagnostic services to young children and their families during the pandemic. We examined the relationship between child characteristics and diagnostic outcome for 335 children, ages 14-78 months, who received ASD tele-assessment conducted by psychologists and pediatricians in an outpatient clinic of a Midwestern academic medical center. We found that clinicians could make a determination about ASD diagnosis for most children (85%) evaluated using tele-assessment. Child clinical characteristics, including TAP scores and clinician ratings of ASD symptoms, were related to diagnostic outcome (i.e. diagnosis of ASD, no ASD, and Unsure about ASD). When all clinical characteristics were examined together, the presence of specific repetitive behaviors predicted ASD diagnosis. We also found that the TAP is effective for making an ASD diagnosis when used as part of comprehensive tele-assessment evaluation in children ⩾ 36 months of age with delayed language. Our study adds to an increasing body of research supporting use of tele-assessment for diagnosis of ASD. Although further research is needed, telemedicine may help families from different backgrounds and geographic locations to access high-quality diagnostic services.