BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023,of which 4 studies wer...We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023,of which 4 studies were performed with whole blood,4 with blood plasma,5 with blood serum,1 with serum neural cell adhesion molecule L1-captured extracellular vesicles,1 with blood cells,and 2 with peripheral blood mononuclear cells.Most of the studies involved children and the study cohorts were largely males.Many of the studies had performed microRNA sequencing or quantitative polymerase chain reaction assays to measure microRNA expression.Only five studies had used real-time polymerase chain reaction assay to validate microRNA expression in autism spectrum disorder subjects compared to controls.The microRNAs that were validated in these studies may be considered as potential candidate biomarkers for autism spectrum disorder and include miR-500a-5p,-197-5p,-424-5p,-664a-3p,-365a-3p,-619-5p,-664a-3p,-3135a,-328-3p,and-500a-5p in blood plasma and miR-151a-3p,-181b-5p,-320a,-328,-433,-489,-572,-663a,-101-3p,-106b-5p,-19b-3p,-195-5p,and-130a-3p in blood serum of children,and miR-15b-5p and-6126 in whole blood of adults.Several important limitations were identified in the studies reviewed,and need to be taken into account in future studies.Further studies are warranted with children and adults having different levels of autism spectrum disorder severity and consideration should be given to using animal models of autism spectrum disorder to investigate the effects of suppressing or overexpressing specific microRNAs as a novel therapy.展开更多
Objective Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by difficulties with communication and social interaction,restricted and repetitive behaviors.Previous studies have indicated that...Objective Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by difficulties with communication and social interaction,restricted and repetitive behaviors.Previous studies have indicated that individuals with ASD exhibit early and lifelong attention deficits,which are closely related to the core symptoms of ASD.Basic visual attention processes may provide a critical foundation for their social communication and interaction abilities.Therefore,this study explores the behavior of children with ASD in capturing attention to changes in topological properties.Methods Our study recruited twenty-seven ASD children diagnosed by professional clinicians according to DSM-5 and twenty-eight typically developing(TD)age-matched controls.In an attention capture task,we recorded the saccadic behaviors of children with ASD and TD in response to topological change(TC)and non-topological change(nTC)stimuli.Saccadic reaction time(SRT),visual search time(VS),and first fixation dwell time(FFDT)were used as indicators of attentional bias.Pearson correlation tests between the clinical assessment scales and attentional bias were conducted.Results This study found that TD children had significantly faster SRT(P<0.05)and VS(P<0.05)for the TC stimuli compared to the nTC stimuli,while the children with ASD did not exhibit significant differences in either measure(P>0.05).Additionally,ASD children demonstrated significantly less attention towards the TC targets(measured by FFDT),in comparison to TD children(P<0.05).Furthermore,ASD children exhibited a significant negative linear correlation between their attentional bias(measured by VS)and their scores on the compulsive subscale(P<0.05).Conclusion The results suggest that children with ASD have difficulty shifting their attention to objects with topological changes during change detection.This atypical attention may affect the child’s cognitive and behavioral development,thereby impacting their social communication and interaction.In sum,our findings indicate that difficulties in attentional capture by TC may be a key feature of ASD.展开更多
BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.Th...BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.展开更多
Autism spectrum disorder(ASD)is an early-onset neurodevelopmental disorder marked by persistent deficits in social communication and interaction,alongside restricted,repetitive patterns of behaviors(RRB),interests,or ...Autism spectrum disorder(ASD)is an early-onset neurodevelopmental disorder marked by persistent deficits in social communication and interaction,alongside restricted,repetitive patterns of behaviors(RRB),interests,or activities.It often co-occurs with various neuropsychiatric disorders,though their frequency varies widely due to unclear boundaries between the core features of ASD and common comorbidities.Catatonia,increasingly noted in neurodevelopmental conditions like ASD,shares striking similarities with ASD in symptomatology,brain mech-anisms,and treatment responses,prompting the question of whether it is a core feature of ASD or a distinct condition.This paper delved into this overlap,ex-ploring the relationship between catatonia and ASD through a narrative review of peer-reviewed literature from 1943 to 2024,sourced from PubMed and psy-chiatric journals.Focusing on ASD diagnostic evolution,symptom overlap with catatonia,and shared neurobiological and therapeutic characteristics,we used thematic analysis to synthesize findings into key areas such as historical nosology,phenomenological overlap,neurobiological parallels,and treatment response.The evidence revealed weak support for separating catatonia from overlapping RRB features of ASD,suggesting that some RRB might align more with comorbid catatonia than intrinsic ASD traits.However,this idea needs further validation through rigorous clinical trials.Clarifying this relationship could refine diagnostic approaches and open doors to targeted treatments,potentially improving out-comes for those affected.展开更多
This article describes a pilot study aiming at generating social interactions between a humanoid robot and adolescents with autism spectrum disorder (ASD), through the practice of a gesture imitation game. The partici...This article describes a pilot study aiming at generating social interactions between a humanoid robot and adolescents with autism spectrum disorder (ASD), through the practice of a gesture imitation game. The participants were a 17-year-old young lady with ASD and intellectual deficit, and a control participant: a preadolescent with ASD but no intellectual deficit (Asperger syndrome). The game is comprised of four phases: greetings, pairing, imitation, and closing. Field educators were involved, playing specific roles: visual or physical inciter. The use of a robot allows for catching the participants’ attention, playing the imitation game for a longer period of time than with a human partner, and preventing the game partner’s negative facial expressions resulting from tiredness, impatience, or boredom. The participants’ behavior was observed in terms of initial approach towards the robot, positioning relative to the robot in terms of distance and orientation, reactions to the robot’s voice or moves, signs of happiness, and imitation attempts. Results suggest a more and more natural approach towards the robot during the sessions, as well as a higher level of social interaction, based on the variations of the parameters listed above. We use these preliminary results to draw the next steps of our research work as well as identify further perspectives, with this aim in mind: improving social interactions with adolescents with ASD and intellectual deficit, allowing for better integration of these people into our societies.展开更多
Autism spectrum disorder(ASD)is a multifaceted neurological developmental condition that manifests in several ways.Nearly all autistic children remain undiagnosed before the age of three.Developmental problems affecti...Autism spectrum disorder(ASD)is a multifaceted neurological developmental condition that manifests in several ways.Nearly all autistic children remain undiagnosed before the age of three.Developmental problems affecting face features are often associated with fundamental brain disorders.The facial evolution of newborns with ASD is quite different from that of typically developing children.Early recognition is very significant to aid families and parents in superstition and denial.Distinguishing facial features from typically developing children is an evident manner to detect children analyzed with ASD.Presently,artificial intelligence(AI)significantly contributes to the emerging computer-aided diagnosis(CAD)of autism and to the evolving interactivemethods that aid in the treatment and reintegration of autistic patients.This study introduces an Ensemble of deep learning models based on the autism spectrum disorder detection in facial images(EDLM-ASDDFI)model.The overarching goal of the EDLM-ASDDFI model is to recognize the difference between facial images of individuals with ASD and normal controls.In the EDLM-ASDDFI method,the primary level of data pre-processing is involved by Gabor filtering(GF).Besides,the EDLM-ASDDFI technique applies the MobileNetV2 model to learn complex features from the pre-processed data.For the ASD detection process,the EDLM-ASDDFI method uses ensemble techniques for classification procedure that encompasses long short-term memory(LSTM),deep belief network(DBN),and hybrid kernel extreme learning machine(HKELM).Finally,the hyperparameter selection of the three deep learning(DL)models can be implemented by the design of the crested porcupine optimizer(CPO)technique.An extensive experiment was conducted to emphasize the improved ASD detection performance of the EDLM-ASDDFI method.The simulation outcomes indicated that the EDLM-ASDDFI technique highlighted betterment over other existing models in terms of numerous performance measures.展开更多
Autism spectrum disorder(ASD)represents a neurodevelopmental disorder that has been the focus of numerous studies on the central nervous system(CNS).The embryological origin of the brain and retina is shared,with the ...Autism spectrum disorder(ASD)represents a neurodevelopmental disorder that has been the focus of numerous studies on the central nervous system(CNS).The embryological origin of the brain and retina is shared,with the axons of retinal ganglion cells(RGC)developing into the optic nerves that enter the brain through the dorsal lateral geniculate nucleus(LGN)of the thalamus,LGN,and other visual cortices.Given the evidence that individuals with ASD exhibit impairments in the visual mechanisms,including deficits in emotional face recognition,and difficulty in maintaining gaze control as well as eye contact,some studies have documented retinal alterations in individuals with ASD.These have been identified through ophthalmic assessments,including optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),and electroretinography(ERG).With the improvements in ASD animal models,it is possible to obtain a better understanding of vision dysfunction in ASD by analyzing the molecular mechanisms of retinal function and structure abnormalities.This review aims to provide a summary of the recent research on ocular alterations in ASD patients and animal models,intending to contribute to further investigation of the eye-brain connection and communication.展开更多
Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retro...Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retrospective analysis was conducted on the diagnosis and treatment data of 104 children with ASD complicated with sleep disorder admitted to Xi’an Traditional Chinese Medicine(TCM)Encephalopathy Hospital from January 2022 to December 2024.Cross-pattern main acupoints were screened via frequency statistics,chi-square test,and factor analysis;pattern-specific auxiliary acupoints were extracted by combining multiple correspondence analysis,cluster analysis,and association rule mining.Results:Ten cross-pattern main acupoints(Baihui,Sishenzhen,Language Area 1,Language Area 2,Neiguan,Shenmen,Yongquan,Xuanzhong)were identified,and acupoint combination schemes for four major TCM patterns(Hyperactivity of Liver and Heart Fire,Deficiency of Kidney Essence,Deficiency of Both Heart and Spleen,Hyperactivity of Liver with Spleen Deficiency)were established.Conclusion:Acupuncture treatment should follow the principle of“regulating spirit and calming the brain as the root,and dredging collaterals based on pattern differentiation as the branch”.The synergy between main and auxiliary acupoints can accurately regulate the disease,providing a basis for precise clinical treatment.展开更多
BACKGROUND Autism spectrum disorder(ASD)is a group of neurodevelopmental disorders that affect children’s social interaction and communication skills and exert a serious effect on children’s perception,language,emot...BACKGROUND Autism spectrum disorder(ASD)is a group of neurodevelopmental disorders that affect children’s social interaction and communication skills and exert a serious effect on children’s perception,language,emotion,and especially social interaction development.AIM To determine the clinical and psychological characteristics of children with ASD according to the C-PEP-3.METHODS This retrospective study included 225 children with autism aged 2-7 years who were treated in our hospital from 2021 to 2024.The C-PEP-3 scale was used for assessment,and the evaluation results were analyzed.RESULTS The comparison of children with ASD in the age groups of<3.5 years and>3.5 years revealed significant differences in the scores of imitation,fine motor,gross motor,hand-eye coordination,cognitive performance,and verbal cognition development areas(P:Pass)(P<0.01).However,no significant differences in the scores of perception,emotion,interpersonal relationships,play,sensation,and language(S:Severe)were observed on pathological scales(P>0.05).The difference in age in the gross motor developmental delay of the scale was the smallest,whereas that of the verbal cognition was the largest,followed by the imitation functional area.An inverse correlation was found between the scores of imitation,perception,hand-eye coordination,and cognitive performance(P)developmental function areas in children with ASD and those of emotion,interpersonal relationships,game and item preferences,sensory patterns,and emotion(S)in the pathological scale(P<0.05).Fine and gross motor skills were negatively correlated with interpersonal relationships,game and item preferences,and emotions in the pathological scale(P<0.05).Age was significantly positively correlated with the scores of imitation,perception,fine motor,gross motor,hand-eye coordination,cognitive performance,and verbal cognition developmental function areas(P)(P<0.05).Further,age was not associated with emotions,interpersonal relationships,game and item preferences,sensory patterns,and emotions(P>0.05).No gender difference was observed between the scores of each developmental area(P)of the scale and the scores of each functional area(S)of the pathological scale.CONCLUSION The C-PEP-3 scale reflects the differences in clinical characteristics of children with autism,and the pathological scale is associated with the severity of developmental function areas.The C-PEP-3 scale can be utilized to assess the effect of age changes on children with autism.Attention in rehabilitation should be focused on addressing the pathological behaviors of children with autism.展开更多
Autism spectrum disorder(ASD)is a range of neurodevelopmental diseases characterized by social dysfunction and stereotypic behaviors.The etiology of ASD remains largely unexplored,resulting in a diverse array of descr...Autism spectrum disorder(ASD)is a range of neurodevelopmental diseases characterized by social dysfunction and stereotypic behaviors.The etiology of ASD remains largely unexplored,resulting in a diverse array of described clinical manifestations and varying degrees of severity.Currently,there are no drugs approved by a supervisory organization that can effectively treat the core symptoms of ASD.Childhood and adolescence are crucial stages for making significant achievements in ASD treatment,necessitating the development of drugs specifically for these periods.Based on the drug targets and mechanisms of action,it can be found that atypical psychotropic medications,anti-inflammatory and antioxidant medications,hormonal medications,ion channel medications,and gastrointestinal medications have shown significant improvement in treating the core symptoms of ASD in both children and adolescents.In addition,comparisons of drugs within the same category regarding efficacy and safety have been made to identify better alternatives and promote drug development.While further evaluation of the effectiveness and safety of these medications is needed,they hold great potential for widespread application in the clinical treatment of the principal symptoms of ASD.展开更多
Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,I...Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,IQ,and adaptive behavior in ASD groups.A total of 257 school-age ASD children were enrolled in our study from January 2017 to June 2021.Their parents completed a standard demographic form,including age at autism diagnosis,gender,school placement,and parents’educational background.The Chinese version of the Wechsler Intelligence Scale for Children,Fourth Edition(WISC-IV)was completed by a certified assessor for each enrolled child.Parents were interviewed on adaptive behavior using the Chinese version of the Adaptive Behavior Assessment System,Second Edition(ABAS-II).The average IQ of school-age ASD children was 76.88(standard deviation(SD)=22.62)and boys had higher IQ levels than girls.The IQ was positively correlated with age.The General Adaptive Composite(GAC)score was 82.47(SD=15.86)and adaptive behavior did not increase with age.ASD children who attended mainstream schools had better adaptive behavior profiles than other children.The mother’s education level showed a significant correlation with the IQ and adaptive behavior of autistic children,while the father’s education level did not.Consequently,better training and support for parents may help autistic children enter mainstream schools,with adaptive training being the most urgently required skill for parents.展开更多
The rising demand for child care is putting a strain on parents of children with autism spectrum disorder(ASD),particularly the mothers.This study investigated Chinese mothers of children with ASD and examined the fac...The rising demand for child care is putting a strain on parents of children with autism spectrum disorder(ASD),particularly the mothers.This study investigated Chinese mothers of children with ASD and examined the factors associated with maternal mental health.An online national survey was completed by the parents of 5077 ASD children and adolescents aged 0–17 years.A total of 28.0%of the mothers reported poor mental health status.Mothers with children aged 10–13 years had a lower chance of having poor mental health status than mothers with children aged 0–2 years(odds ratio(OR)0.63,95%confidence interval(CI)0.43–0.91).Mothers of children with high-functioning autism were less likely to have poor mental health status than those of children with low-functioning autism(OR 0.76,95%CI 0.62–0.94).Having children with comorbidities was related with a higher risk of poor mental status(OR 1.56,95%CI 1.35–1.81),as were having conflicts with other family members(OR 1.44,95%CI 1.22–1.70)and providing full-time care(OR 1.22,CI 1.06–1.41).A higher-than-average family income was associated with lower risk of having poor mental health status(OR 0.70,95%CI 0.58–0.82).Factors related to the children and family,and providing full-time care,have a significant effect on mothers’mental health status.Reducing obstacles to work and social interaction,as well as tackling the financial burden of raising an ASD child,may help improve the well-being of mothers.展开更多
BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastroint...BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastrointestinal issues.Various interventions have been explored to address these challenges,including dietary modifications,vitamin supplementation,feeding therapy,and behavioral interventions.AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD.We examine the effectiveness of dietary interventions,vitamin supplements,feeding therapy,behavioral interventions,and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.METHODS We systematically searched relevant literature up to June 2024,using databases such as PubMed,PsycINFO,and Scopus.Studies were included if they investigated dietary interventions,nutritional supplements,or behavioral strategies to improve feeding behaviors in children with ASD.We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes.Data extraction focused on intervention types,study designs,participant characteristics,outcomes measured,and intervention effectiveness.RESULTS The review identified 316 studies that met the inclusion criteria.The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies,the effectiveness of these approaches varies.Feeding therapy and behavioral interventions,including gradual exposure and positive reinforcement,promise to improve food acceptance and mealtime behaviors.The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications,supplementation,feeding therapy,and behavioral strategies.The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes.Collaborative efforts among healthcare providers,educators,and families are essential to optimize this population's nutritional health and feeding practices.Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.展开更多
Complex brain diseases seriously endanger human health,and early diagnostic biomarkers and effective treatments are currently lacking.Due to ethical constraints on human research,establishing monkey models is crucial ...Complex brain diseases seriously endanger human health,and early diagnostic biomarkers and effective treatments are currently lacking.Due to ethical constraints on human research,establishing monkey models is crucial to address these issues.With the rapid development of technology,transgenic monkey models of a range of brain diseases,especially autism spectrum disorder(ASD),have been successfully established.However,to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies,there is still a lack of a standard tool,i.e.,a system for collecting and analyzing the daily behaviors of brain disease model monkeys.Therefore,with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes,we established a standard daily behavior collection and analysis system,including behavioral data collection protocols and a monkey daily behavior ethogram(MDBE)for rhesus and cynomolgus monkeys,which are the most commonly used non-human primates in model construction.Then,we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,Text Revision(DSM-5-TR),which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms.We then established a sub-ethogram(ASD monkey core behavior ethogram(MCBE-ASD))specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE.Subsequently,we demonstrated the high reproducibility of the system.展开更多
The effective intervention strategy for autism spectrum disorder(ASD)are currently limited.Herein,we attempted to evaluate the potential of L-proline(Pro),a multifunctional amino acid,in ameliorating autismlike behavi...The effective intervention strategy for autism spectrum disorder(ASD)are currently limited.Herein,we attempted to evaluate the potential of L-proline(Pro),a multifunctional amino acid,in ameliorating autismlike behaviors and clarify the molecular mechanisms involved by using the typical valproic acid(VPA)-induced mouse model of ASD.Pro significantly attenuates repetitive behaviors and social dysfunction in ASD mice.The correlation analysis revealed that the beneficial effects of Pro on autism-like behaviors are related to the modulation of gut microbiota structure and composition.The histological analysis revealed that Pro could reverse the decrease of Nissl-positive cells in the prefrontal cortex(PFC)induced by VPA exposure.RNA sequencing demonstrated that Pro can also alter the PFC transcriptomic profile distinguished by the regulation of genes involved in Parkinson disease,neuroactive ligand-receptor interaction,oxidative phosphorylation,and mitogen activated protein kinase signaling pathway.Overall,dietary Pro supplementation may be a promising intervention strategy for ASD.展开更多
BACKGROUND Early diagnosis and therapeutic interventions can greatly enhance the developmental trajectory of children with autism spectrum disorder(ASD).However,the etiology of ASD is not completely understood.The pre...BACKGROUND Early diagnosis and therapeutic interventions can greatly enhance the developmental trajectory of children with autism spectrum disorder(ASD).However,the etiology of ASD is not completely understood.The presence of confounding factors from environment and genetics has increased the difficulty of the identification of diagnostic biomarkers for ASD.AIM To estimate and interpret the causal relationship between ASD and metabolite profile,taking into consideration both genetic and environmental influences.METHODS A two-sample Mendelian randomization(MR)analysis was conducted using summarized data from large-scale genome-wide association studies(GWAS)including a metabolite GWAS dataset covering 453 metabolites from 7824 European and an ASD GWAS dataset comprising 18381 ASD cases and 27969 healthy controls.Metabolites in plasma were set as exposures with ASD as the main outcome.The causal relationships were estimated using the inverse variant weight(IVW)algorithm.We also performed leave-one-out sensitivity tests to validate the robustness of the results.Based on the drafted metabolites,enrichment analysis was conducted to interpret the association via constructing a protein-protein interaction network with multi-scale evidence from databases including Infinome,SwissTargetPrediction,STRING,and Metascape.RESULTS Des-Arg(9)-bradykinin was identified as a causal metabolite that increases the risk of ASD(β=0.262,SE=0.064,P_(IVW)=4.64×10^(-5)).The association was robust,with no significant heterogeneity among instrument variables(P_(MR Egger)=0.663,P_(IVW)=0.906)and no evidence of pleiotropy(P=0.949).Neuroinflammation and the response to stimulus were suggested as potential biological processes mediating the association between Des-Arg(9)bradykinin and ASD.CONCLUSION Through the application of MR,this study provides practical insights into the potential causal association between plasma metabolites and ASD.These findings offer perspectives for the discovery of diagnostic or predictive biomarkers to support clinical practice in treating ASD.展开更多
Autism Spectrum Disorder(ASD)is a common neurodevelopmental disorder in children,characterized by social interaction,communication difficulties,and repetitive and stereotyped behaviors.Existing intervention methods ha...Autism Spectrum Disorder(ASD)is a common neurodevelopmental disorder in children,characterized by social interaction,communication difficulties,and repetitive and stereotyped behaviors.Existing intervention methods have limitations,such as requiring long treatment periods and needing to be more convenient to implement.Extended Reality(XR)technology offers a virtual environment to enhance children's social,communication,and self-regulation skills.This paper compares XR theoretical models,application examples,and intervention effects.The study reveals that XR intervention therapy is mainly based on cognitive rehabilitation,teaching,and social-emotional learning theories.It utilizes algorithms,models,artificial intelligence(AI),eye-tracking,and other technologies for interaction,achieving diverse intervention outcomes.Participants showed effective improvement in competency barriers using XR-based multimodal interactive platforms.However,Mixed Reality(MR)technology still requires further development.Future research should explore multimsodal interaction technologies combining XR and AI,optimize models,prioritize the development of MR intervention scenarios,and sustain an optimal intervention level.展开更多
This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder(ASD) in Chinese children.We targeted the population of 6 to 12-year-old children for this prevalence study by multis...This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder(ASD) in Chinese children.We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling.The Modified Chinese Autism Spectrum Rating Scale was used for the screening process.Of the target population of 142,086 children,88.5%(n=125,806) participated in the study.A total of 363 children were confirmed as having ASD.The observed ASD prevalence rate was 0.29%(95% CI:0.26%-0.32%) for the overall population.After adjustment for response rates,the estimated number of ASD cases was867 in the target population sample,thereby achieving an estimated prevalence of 0.70%(95% CI:0.64%-0.74%).The prevalence was significantly higher in boys than in girls(0.95%;95% CI:0.87%-1.02% versus 0.30%;95%CI:0.26%-0.34%;P <0.001).Of the 363 confirmed ASD cases,43.3% were newly diagnosed,and most of those(90.4%) were attending regular schools,and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity.Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.展开更多
Background: Active video games(AVGs) encourage whole body movements to interact or control the gaming system, allowing the opportunity for skill development. Children with autism spectrum disorder(ASD) show decreased ...Background: Active video games(AVGs) encourage whole body movements to interact or control the gaming system, allowing the opportunity for skill development. Children with autism spectrum disorder(ASD) show decreased fundamental movement skills in comparison with their typically developing(TD) peers and might benefit from this approach. This pilot study investigates whether playing sports AVGs can increase the actual and perceived object control(OC) skills of 11 children with ASD aged 6–10 years in comparison to 19 TD children of a similar age.Feasibility was a secondary aim.Methods: Actual(Test of Gross Motor Development) and perceived OC skills(Pictorial Scale of Perceived Movement Skill Competence for Young Children) were assessed before and after the intervention(6 × 45 min).Results: Actual skill scores were not improved in either group. The ASD group improved in perceived skill. All children completed the required dose and parents reported the intervention was feasible.Conclusion: The use of AVGs as a play-based intervention may not provide enough opportunity for children to perform the correct movement patterns to influence skill. However, play of such games may influence perceptions of skill ability in children with ASD, which could improve motivation to participate in physical activities.展开更多
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
文摘We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023,of which 4 studies were performed with whole blood,4 with blood plasma,5 with blood serum,1 with serum neural cell adhesion molecule L1-captured extracellular vesicles,1 with blood cells,and 2 with peripheral blood mononuclear cells.Most of the studies involved children and the study cohorts were largely males.Many of the studies had performed microRNA sequencing or quantitative polymerase chain reaction assays to measure microRNA expression.Only five studies had used real-time polymerase chain reaction assay to validate microRNA expression in autism spectrum disorder subjects compared to controls.The microRNAs that were validated in these studies may be considered as potential candidate biomarkers for autism spectrum disorder and include miR-500a-5p,-197-5p,-424-5p,-664a-3p,-365a-3p,-619-5p,-664a-3p,-3135a,-328-3p,and-500a-5p in blood plasma and miR-151a-3p,-181b-5p,-320a,-328,-433,-489,-572,-663a,-101-3p,-106b-5p,-19b-3p,-195-5p,and-130a-3p in blood serum of children,and miR-15b-5p and-6126 in whole blood of adults.Several important limitations were identified in the studies reviewed,and need to be taken into account in future studies.Further studies are warranted with children and adults having different levels of autism spectrum disorder severity and consideration should be given to using animal models of autism spectrum disorder to investigate the effects of suppressing or overexpressing specific microRNAs as a novel therapy.
文摘Objective Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by difficulties with communication and social interaction,restricted and repetitive behaviors.Previous studies have indicated that individuals with ASD exhibit early and lifelong attention deficits,which are closely related to the core symptoms of ASD.Basic visual attention processes may provide a critical foundation for their social communication and interaction abilities.Therefore,this study explores the behavior of children with ASD in capturing attention to changes in topological properties.Methods Our study recruited twenty-seven ASD children diagnosed by professional clinicians according to DSM-5 and twenty-eight typically developing(TD)age-matched controls.In an attention capture task,we recorded the saccadic behaviors of children with ASD and TD in response to topological change(TC)and non-topological change(nTC)stimuli.Saccadic reaction time(SRT),visual search time(VS),and first fixation dwell time(FFDT)were used as indicators of attentional bias.Pearson correlation tests between the clinical assessment scales and attentional bias were conducted.Results This study found that TD children had significantly faster SRT(P<0.05)and VS(P<0.05)for the TC stimuli compared to the nTC stimuli,while the children with ASD did not exhibit significant differences in either measure(P>0.05).Additionally,ASD children demonstrated significantly less attention towards the TC targets(measured by FFDT),in comparison to TD children(P<0.05).Furthermore,ASD children exhibited a significant negative linear correlation between their attentional bias(measured by VS)and their scores on the compulsive subscale(P<0.05).Conclusion The results suggest that children with ASD have difficulty shifting their attention to objects with topological changes during change detection.This atypical attention may affect the child’s cognitive and behavioral development,thereby impacting their social communication and interaction.In sum,our findings indicate that difficulties in attentional capture by TC may be a key feature of ASD.
文摘BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.
文摘Autism spectrum disorder(ASD)is an early-onset neurodevelopmental disorder marked by persistent deficits in social communication and interaction,alongside restricted,repetitive patterns of behaviors(RRB),interests,or activities.It often co-occurs with various neuropsychiatric disorders,though their frequency varies widely due to unclear boundaries between the core features of ASD and common comorbidities.Catatonia,increasingly noted in neurodevelopmental conditions like ASD,shares striking similarities with ASD in symptomatology,brain mech-anisms,and treatment responses,prompting the question of whether it is a core feature of ASD or a distinct condition.This paper delved into this overlap,ex-ploring the relationship between catatonia and ASD through a narrative review of peer-reviewed literature from 1943 to 2024,sourced from PubMed and psy-chiatric journals.Focusing on ASD diagnostic evolution,symptom overlap with catatonia,and shared neurobiological and therapeutic characteristics,we used thematic analysis to synthesize findings into key areas such as historical nosology,phenomenological overlap,neurobiological parallels,and treatment response.The evidence revealed weak support for separating catatonia from overlapping RRB features of ASD,suggesting that some RRB might align more with comorbid catatonia than intrinsic ASD traits.However,this idea needs further validation through rigorous clinical trials.Clarifying this relationship could refine diagnostic approaches and open doors to targeted treatments,potentially improving out-comes for those affected.
文摘This article describes a pilot study aiming at generating social interactions between a humanoid robot and adolescents with autism spectrum disorder (ASD), through the practice of a gesture imitation game. The participants were a 17-year-old young lady with ASD and intellectual deficit, and a control participant: a preadolescent with ASD but no intellectual deficit (Asperger syndrome). The game is comprised of four phases: greetings, pairing, imitation, and closing. Field educators were involved, playing specific roles: visual or physical inciter. The use of a robot allows for catching the participants’ attention, playing the imitation game for a longer period of time than with a human partner, and preventing the game partner’s negative facial expressions resulting from tiredness, impatience, or boredom. The participants’ behavior was observed in terms of initial approach towards the robot, positioning relative to the robot in terms of distance and orientation, reactions to the robot’s voice or moves, signs of happiness, and imitation attempts. Results suggest a more and more natural approach towards the robot during the sessions, as well as a higher level of social interaction, based on the variations of the parameters listed above. We use these preliminary results to draw the next steps of our research work as well as identify further perspectives, with this aim in mind: improving social interactions with adolescents with ASD and intellectual deficit, allowing for better integration of these people into our societies.
基金Researchers supporting Project number(RSPD2025R1107),King Saud University,Riyadh,Saudi Arabia.
文摘Autism spectrum disorder(ASD)is a multifaceted neurological developmental condition that manifests in several ways.Nearly all autistic children remain undiagnosed before the age of three.Developmental problems affecting face features are often associated with fundamental brain disorders.The facial evolution of newborns with ASD is quite different from that of typically developing children.Early recognition is very significant to aid families and parents in superstition and denial.Distinguishing facial features from typically developing children is an evident manner to detect children analyzed with ASD.Presently,artificial intelligence(AI)significantly contributes to the emerging computer-aided diagnosis(CAD)of autism and to the evolving interactivemethods that aid in the treatment and reintegration of autistic patients.This study introduces an Ensemble of deep learning models based on the autism spectrum disorder detection in facial images(EDLM-ASDDFI)model.The overarching goal of the EDLM-ASDDFI model is to recognize the difference between facial images of individuals with ASD and normal controls.In the EDLM-ASDDFI method,the primary level of data pre-processing is involved by Gabor filtering(GF).Besides,the EDLM-ASDDFI technique applies the MobileNetV2 model to learn complex features from the pre-processed data.For the ASD detection process,the EDLM-ASDDFI method uses ensemble techniques for classification procedure that encompasses long short-term memory(LSTM),deep belief network(DBN),and hybrid kernel extreme learning machine(HKELM).Finally,the hyperparameter selection of the three deep learning(DL)models can be implemented by the design of the crested porcupine optimizer(CPO)technique.An extensive experiment was conducted to emphasize the improved ASD detection performance of the EDLM-ASDDFI method.The simulation outcomes indicated that the EDLM-ASDDFI technique highlighted betterment over other existing models in terms of numerous performance measures.
基金Supported by Jiangsu Department of Science and Technology Key R&D Program(No.BE2023777)the Jiangsu Commission of Health(No.H2022185)Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University)Clinical Capacity Enhancement Project(No.JSPH-MB-2023-18).
文摘Autism spectrum disorder(ASD)represents a neurodevelopmental disorder that has been the focus of numerous studies on the central nervous system(CNS).The embryological origin of the brain and retina is shared,with the axons of retinal ganglion cells(RGC)developing into the optic nerves that enter the brain through the dorsal lateral geniculate nucleus(LGN)of the thalamus,LGN,and other visual cortices.Given the evidence that individuals with ASD exhibit impairments in the visual mechanisms,including deficits in emotional face recognition,and difficulty in maintaining gaze control as well as eye contact,some studies have documented retinal alterations in individuals with ASD.These have been identified through ophthalmic assessments,including optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),and electroretinography(ERG).With the improvements in ASD animal models,it is possible to obtain a better understanding of vision dysfunction in ASD by analyzing the molecular mechanisms of retinal function and structure abnormalities.This review aims to provide a summary of the recent research on ocular alterations in ASD patients and animal models,intending to contribute to further investigation of the eye-brain connection and communication.
基金Song Hujie’s Inheritance Studio of National Renowned Traditional Chinese Medicine Experts.
文摘Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retrospective analysis was conducted on the diagnosis and treatment data of 104 children with ASD complicated with sleep disorder admitted to Xi’an Traditional Chinese Medicine(TCM)Encephalopathy Hospital from January 2022 to December 2024.Cross-pattern main acupoints were screened via frequency statistics,chi-square test,and factor analysis;pattern-specific auxiliary acupoints were extracted by combining multiple correspondence analysis,cluster analysis,and association rule mining.Results:Ten cross-pattern main acupoints(Baihui,Sishenzhen,Language Area 1,Language Area 2,Neiguan,Shenmen,Yongquan,Xuanzhong)were identified,and acupoint combination schemes for four major TCM patterns(Hyperactivity of Liver and Heart Fire,Deficiency of Kidney Essence,Deficiency of Both Heart and Spleen,Hyperactivity of Liver with Spleen Deficiency)were established.Conclusion:Acupuncture treatment should follow the principle of“regulating spirit and calming the brain as the root,and dredging collaterals based on pattern differentiation as the branch”.The synergy between main and auxiliary acupoints can accurately regulate the disease,providing a basis for precise clinical treatment.
文摘BACKGROUND Autism spectrum disorder(ASD)is a group of neurodevelopmental disorders that affect children’s social interaction and communication skills and exert a serious effect on children’s perception,language,emotion,and especially social interaction development.AIM To determine the clinical and psychological characteristics of children with ASD according to the C-PEP-3.METHODS This retrospective study included 225 children with autism aged 2-7 years who were treated in our hospital from 2021 to 2024.The C-PEP-3 scale was used for assessment,and the evaluation results were analyzed.RESULTS The comparison of children with ASD in the age groups of<3.5 years and>3.5 years revealed significant differences in the scores of imitation,fine motor,gross motor,hand-eye coordination,cognitive performance,and verbal cognition development areas(P:Pass)(P<0.01).However,no significant differences in the scores of perception,emotion,interpersonal relationships,play,sensation,and language(S:Severe)were observed on pathological scales(P>0.05).The difference in age in the gross motor developmental delay of the scale was the smallest,whereas that of the verbal cognition was the largest,followed by the imitation functional area.An inverse correlation was found between the scores of imitation,perception,hand-eye coordination,and cognitive performance(P)developmental function areas in children with ASD and those of emotion,interpersonal relationships,game and item preferences,sensory patterns,and emotion(S)in the pathological scale(P<0.05).Fine and gross motor skills were negatively correlated with interpersonal relationships,game and item preferences,and emotions in the pathological scale(P<0.05).Age was significantly positively correlated with the scores of imitation,perception,fine motor,gross motor,hand-eye coordination,cognitive performance,and verbal cognition developmental function areas(P)(P<0.05).Further,age was not associated with emotions,interpersonal relationships,game and item preferences,sensory patterns,and emotions(P>0.05).No gender difference was observed between the scores of each developmental area(P)of the scale and the scores of each functional area(S)of the pathological scale.CONCLUSION The C-PEP-3 scale reflects the differences in clinical characteristics of children with autism,and the pathological scale is associated with the severity of developmental function areas.The C-PEP-3 scale can be utilized to assess the effect of age changes on children with autism.Attention in rehabilitation should be focused on addressing the pathological behaviors of children with autism.
基金supported by the Key-Area Research and Development Program of Guangdong Province(No.2019B030335001)the National Natural Science Foundation of China(No.32200815)+1 种基金the National Social Science Foundation of China(No.20&ZD296)the China Postdoctoral Science Foundation(No.2022M721218)。
文摘Autism spectrum disorder(ASD)is a range of neurodevelopmental diseases characterized by social dysfunction and stereotypic behaviors.The etiology of ASD remains largely unexplored,resulting in a diverse array of described clinical manifestations and varying degrees of severity.Currently,there are no drugs approved by a supervisory organization that can effectively treat the core symptoms of ASD.Childhood and adolescence are crucial stages for making significant achievements in ASD treatment,necessitating the development of drugs specifically for these periods.Based on the drug targets and mechanisms of action,it can be found that atypical psychotropic medications,anti-inflammatory and antioxidant medications,hormonal medications,ion channel medications,and gastrointestinal medications have shown significant improvement in treating the core symptoms of ASD in both children and adolescents.In addition,comparisons of drugs within the same category regarding efficacy and safety have been made to identify better alternatives and promote drug development.While further evaluation of the effectiveness and safety of these medications is needed,they hold great potential for widespread application in the clinical treatment of the principal symptoms of ASD.
基金supported by the Zhejiang Provincial Natural Science Foundation of China(No.LGF20H090015)。
文摘Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,IQ,and adaptive behavior in ASD groups.A total of 257 school-age ASD children were enrolled in our study from January 2017 to June 2021.Their parents completed a standard demographic form,including age at autism diagnosis,gender,school placement,and parents’educational background.The Chinese version of the Wechsler Intelligence Scale for Children,Fourth Edition(WISC-IV)was completed by a certified assessor for each enrolled child.Parents were interviewed on adaptive behavior using the Chinese version of the Adaptive Behavior Assessment System,Second Edition(ABAS-II).The average IQ of school-age ASD children was 76.88(standard deviation(SD)=22.62)and boys had higher IQ levels than girls.The IQ was positively correlated with age.The General Adaptive Composite(GAC)score was 82.47(SD=15.86)and adaptive behavior did not increase with age.ASD children who attended mainstream schools had better adaptive behavior profiles than other children.The mother’s education level showed a significant correlation with the IQ and adaptive behavior of autistic children,while the father’s education level did not.Consequently,better training and support for parents may help autistic children enter mainstream schools,with adaptive training being the most urgently required skill for parents.
基金supported by the Beijing Natural Science Foundation(No.J230013),China。
文摘The rising demand for child care is putting a strain on parents of children with autism spectrum disorder(ASD),particularly the mothers.This study investigated Chinese mothers of children with ASD and examined the factors associated with maternal mental health.An online national survey was completed by the parents of 5077 ASD children and adolescents aged 0–17 years.A total of 28.0%of the mothers reported poor mental health status.Mothers with children aged 10–13 years had a lower chance of having poor mental health status than mothers with children aged 0–2 years(odds ratio(OR)0.63,95%confidence interval(CI)0.43–0.91).Mothers of children with high-functioning autism were less likely to have poor mental health status than those of children with low-functioning autism(OR 0.76,95%CI 0.62–0.94).Having children with comorbidities was related with a higher risk of poor mental status(OR 1.56,95%CI 1.35–1.81),as were having conflicts with other family members(OR 1.44,95%CI 1.22–1.70)and providing full-time care(OR 1.22,CI 1.06–1.41).A higher-than-average family income was associated with lower risk of having poor mental health status(OR 0.70,95%CI 0.58–0.82).Factors related to the children and family,and providing full-time care,have a significant effect on mothers’mental health status.Reducing obstacles to work and social interaction,as well as tackling the financial burden of raising an ASD child,may help improve the well-being of mothers.
文摘BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastrointestinal issues.Various interventions have been explored to address these challenges,including dietary modifications,vitamin supplementation,feeding therapy,and behavioral interventions.AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD.We examine the effectiveness of dietary interventions,vitamin supplements,feeding therapy,behavioral interventions,and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.METHODS We systematically searched relevant literature up to June 2024,using databases such as PubMed,PsycINFO,and Scopus.Studies were included if they investigated dietary interventions,nutritional supplements,or behavioral strategies to improve feeding behaviors in children with ASD.We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes.Data extraction focused on intervention types,study designs,participant characteristics,outcomes measured,and intervention effectiveness.RESULTS The review identified 316 studies that met the inclusion criteria.The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies,the effectiveness of these approaches varies.Feeding therapy and behavioral interventions,including gradual exposure and positive reinforcement,promise to improve food acceptance and mealtime behaviors.The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications,supplementation,feeding therapy,and behavioral strategies.The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes.Collaborative efforts among healthcare providers,educators,and families are essential to optimize this population's nutritional health and feeding practices.Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.
基金supported by the Key-Area Research and Development Program of Guangdong Province(No.2019B030335001)the STI2030-Major Projects(No.2021ZD0200900)+9 种基金the National Key Research and Development Program of China(Nos.2021YFF0702700 and 2018YFA0801403)the National Natural Science Foundation of China(Nos.81960422,32100801,82101241,82360226,82160923,82260929,82374425,and 32460194)the Strategic Priority Research Program of the Chinese Academy of Sciences(CAS)(No.XDB32060200)the STI2030-Major Projects(Nos.2022ZD0205200 and 2022ZD0212700)the Science and Technology Department of Yunnan Province(Nos.202305AH340006 and 202305AH340007)the Yunnan Fundamental Research Projects(Nos.202201AT070153 and 202201AT070139)the Science and Technology Project of Yunnan Province(No.202101AY070001-001)the Yunnan Revitalization Talent Support Program(No.YNWR-QNBJ2019-043)the CAS“Light of West China”Programthe Yunnan Revitalization Talents Support Plan。
文摘Complex brain diseases seriously endanger human health,and early diagnostic biomarkers and effective treatments are currently lacking.Due to ethical constraints on human research,establishing monkey models is crucial to address these issues.With the rapid development of technology,transgenic monkey models of a range of brain diseases,especially autism spectrum disorder(ASD),have been successfully established.However,to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies,there is still a lack of a standard tool,i.e.,a system for collecting and analyzing the daily behaviors of brain disease model monkeys.Therefore,with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes,we established a standard daily behavior collection and analysis system,including behavioral data collection protocols and a monkey daily behavior ethogram(MDBE)for rhesus and cynomolgus monkeys,which are the most commonly used non-human primates in model construction.Then,we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,Text Revision(DSM-5-TR),which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms.We then established a sub-ethogram(ASD monkey core behavior ethogram(MCBE-ASD))specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE.Subsequently,we demonstrated the high reproducibility of the system.
基金supported by Beijing Natural Science Foundation(7222249).
文摘The effective intervention strategy for autism spectrum disorder(ASD)are currently limited.Herein,we attempted to evaluate the potential of L-proline(Pro),a multifunctional amino acid,in ameliorating autismlike behaviors and clarify the molecular mechanisms involved by using the typical valproic acid(VPA)-induced mouse model of ASD.Pro significantly attenuates repetitive behaviors and social dysfunction in ASD mice.The correlation analysis revealed that the beneficial effects of Pro on autism-like behaviors are related to the modulation of gut microbiota structure and composition.The histological analysis revealed that Pro could reverse the decrease of Nissl-positive cells in the prefrontal cortex(PFC)induced by VPA exposure.RNA sequencing demonstrated that Pro can also alter the PFC transcriptomic profile distinguished by the regulation of genes involved in Parkinson disease,neuroactive ligand-receptor interaction,oxidative phosphorylation,and mitogen activated protein kinase signaling pathway.Overall,dietary Pro supplementation may be a promising intervention strategy for ASD.
基金Supported by The Guangdong Basic and Applied Basic Research Foundation,No.2023A1515011432The Guangzhou Science and Technology Planning Project,No.2023A04J0627and National Natural Science Foundation of China,No.82004256.
文摘BACKGROUND Early diagnosis and therapeutic interventions can greatly enhance the developmental trajectory of children with autism spectrum disorder(ASD).However,the etiology of ASD is not completely understood.The presence of confounding factors from environment and genetics has increased the difficulty of the identification of diagnostic biomarkers for ASD.AIM To estimate and interpret the causal relationship between ASD and metabolite profile,taking into consideration both genetic and environmental influences.METHODS A two-sample Mendelian randomization(MR)analysis was conducted using summarized data from large-scale genome-wide association studies(GWAS)including a metabolite GWAS dataset covering 453 metabolites from 7824 European and an ASD GWAS dataset comprising 18381 ASD cases and 27969 healthy controls.Metabolites in plasma were set as exposures with ASD as the main outcome.The causal relationships were estimated using the inverse variant weight(IVW)algorithm.We also performed leave-one-out sensitivity tests to validate the robustness of the results.Based on the drafted metabolites,enrichment analysis was conducted to interpret the association via constructing a protein-protein interaction network with multi-scale evidence from databases including Infinome,SwissTargetPrediction,STRING,and Metascape.RESULTS Des-Arg(9)-bradykinin was identified as a causal metabolite that increases the risk of ASD(β=0.262,SE=0.064,P_(IVW)=4.64×10^(-5)).The association was robust,with no significant heterogeneity among instrument variables(P_(MR Egger)=0.663,P_(IVW)=0.906)and no evidence of pleiotropy(P=0.949).Neuroinflammation and the response to stimulus were suggested as potential biological processes mediating the association between Des-Arg(9)bradykinin and ASD.CONCLUSION Through the application of MR,this study provides practical insights into the potential causal association between plasma metabolites and ASD.These findings offer perspectives for the discovery of diagnostic or predictive biomarkers to support clinical practice in treating ASD.
基金supported by grants from the National Natural Science Foundation of China(82301735)The University Synergy Innovation Program of Anhui Province(GXXT-2021-003)The Basic and Clinical Collaborative Research Enhancement Programme of Anhui Medical University(2022xkjT016).
文摘Autism Spectrum Disorder(ASD)is a common neurodevelopmental disorder in children,characterized by social interaction,communication difficulties,and repetitive and stereotyped behaviors.Existing intervention methods have limitations,such as requiring long treatment periods and needing to be more convenient to implement.Extended Reality(XR)technology offers a virtual environment to enhance children's social,communication,and self-regulation skills.This paper compares XR theoretical models,application examples,and intervention effects.The study reveals that XR intervention therapy is mainly based on cognitive rehabilitation,teaching,and social-emotional learning theories.It utilizes algorithms,models,artificial intelligence(AI),eye-tracking,and other technologies for interaction,achieving diverse intervention outcomes.Participants showed effective improvement in competency barriers using XR-based multimodal interactive platforms.However,Mixed Reality(MR)technology still requires further development.Future research should explore multimsodal interaction technologies combining XR and AI,optimize models,prioritize the development of MR intervention scenarios,and sustain an optimal intervention level.
基金supported by the National Health Commission of the People’s Republic of China (201302002,Clinical Trial NCT02200679)。
文摘This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder(ASD) in Chinese children.We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling.The Modified Chinese Autism Spectrum Rating Scale was used for the screening process.Of the target population of 142,086 children,88.5%(n=125,806) participated in the study.A total of 363 children were confirmed as having ASD.The observed ASD prevalence rate was 0.29%(95% CI:0.26%-0.32%) for the overall population.After adjustment for response rates,the estimated number of ASD cases was867 in the target population sample,thereby achieving an estimated prevalence of 0.70%(95% CI:0.64%-0.74%).The prevalence was significantly higher in boys than in girls(0.95%;95% CI:0.87%-1.02% versus 0.30%;95%CI:0.26%-0.34%;P <0.001).Of the 363 confirmed ASD cases,43.3% were newly diagnosed,and most of those(90.4%) were attending regular schools,and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity.Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.
基金supported by an Alfred Deakin Fellowshipsupported by internal university funding
文摘Background: Active video games(AVGs) encourage whole body movements to interact or control the gaming system, allowing the opportunity for skill development. Children with autism spectrum disorder(ASD) show decreased fundamental movement skills in comparison with their typically developing(TD) peers and might benefit from this approach. This pilot study investigates whether playing sports AVGs can increase the actual and perceived object control(OC) skills of 11 children with ASD aged 6–10 years in comparison to 19 TD children of a similar age.Feasibility was a secondary aim.Methods: Actual(Test of Gross Motor Development) and perceived OC skills(Pictorial Scale of Perceived Movement Skill Competence for Young Children) were assessed before and after the intervention(6 × 45 min).Results: Actual skill scores were not improved in either group. The ASD group improved in perceived skill. All children completed the required dose and parents reported the intervention was feasible.Conclusion: The use of AVGs as a play-based intervention may not provide enough opportunity for children to perform the correct movement patterns to influence skill. However, play of such games may influence perceptions of skill ability in children with ASD, which could improve motivation to participate in physical activities.
