Author Interviews, Autism, Pediatrics, Pediatrics / 13.01.2015

Terisa P. Gabrielsen, PhD, NCSP Assistant Professor, School Psychology Dept. of Counseling Psychology and Special Education Brigham Young University, Provo, UT 84602MedicalResearch.com Interview with: Terisa P. Gabrielsen, PhD, NCSP Assistant Professor, School Psychology Dept. of Counseling Psychology and Special Education Brigham Young University, Provo, UT 84602 Medical Research: What is the background for this study? What are the main findings? Dr. Gabrielsen: One of the keys to improving outcomes for individuals with outcomes is to begin intervention as early as possible, which means we need to identify autism symptoms as early as possible, preferably during the early toddler years.  The current study grew out of a screening feasibility study to see what would happen if pediatricians followed the AAP guidelines for screening every child for autism at ages 18 and 24 months as part of their regular pediatric care appointments.  That study  was conducted in a large, independent community pediatrics practice.  We found that universal screening of 796 patients helped to identify 10 toddlers with autism who had not previously been referred for evaluations.  Physicians had previously identified 3 others with autism in the group, and toddlers with other delays, such as language delays, were also identified through the screening process.  We wondered what some possible causes were for the low rate of autism referrals and designed the current study to look for what information was available to a pediatrician during the timespan of a typical pediatric exam.  We found that even in toddlers with autism, a brief (10-minute) sample contains an overwhelming ratio of typical behaviors (averaging 89%) compared to infrequent atypical behaviors (11%)  that would indicate the presence of autism.  We had autism experts identifying the behaviors from videos of the evaluations of children in the previous study, so they had many luxuries that a clinician doesn't have during an exam (i.e., ability to focus on one aspect of development, ability to rewind and re-view behaviors).  After watching the 10-minute video observations, we asked our experts, "Would you refer this child for an autism evaluation?"  We found that even the experts missed referring a child for an autism evaluation 39% of the time when the only data available were the brief observations. (more…)
Author Interviews, Autism, Toxin Research / 23.12.2014

MedicalResearch.com Interview with: Raanan Raz, PhD Visiting Scientist Harvard School of Public Health Medical Research: What is the background for this study? What are the main findings? Dr. Raz: Air pollution contains various toxicants that have been found to be associated with neurotoxicity and adverse effects on the fetus in utero. Several studies have explored associations of air pollution with autism spectrum disorders (ASD). These studies suggest increased chances of having a child with autism spectrum disorders with higher exposures to diesel particulate matter (PM), criteria pollutants and some organic materials as well as closer proximity to a freeway. (more…)
Author Interviews, Autism, JAMA, OBGYNE, UC Davis / 10.12.2014

Cheryl K. Walker, MD Associate Professor Department of Obstetrics & Gynecology Faculty, The MIND Institute School of Medicine, University of California, Davis MedicalResearch.com Interview with: Cheryl K. Walker, MD Associate Professor Department of Obstetrics & Gynecology Faculty, The MIND Institute School of Medicine, University of California, Davis Medical Research: What is the background for this study? What are the main findings? Dr. Walker: Autism spectrum disorder (ASD) is a neurobehavioral condition identified in 1 in 68 U.S. children and is part of a broader group of developmental disabilities that affects 1 in 6 children.  Growing evidence suggests that Autism spectrum disorder and developmental delay originate during fetal life.  Preeclampsia is a complicated and frequently dangerous pregnancy condition that appears to arise from a shallow placental connection and may increase the risk of abnormal neurodevelopment through several pathways. Medical Research: What are the main findings? Dr. Walker: Children with Autism spectrum disorder were more than twice as likely to have been exposed to preeclampsia compared with children with typical development.  Risk for ASD was increased further in children born to mothers with more severe presentations of preeclampsia.  Mothers of children with developmental delay were more than 5 times more likely to have had severe forms preeclampsia – often with evidence of reduced placental function – compared with mothers of children with typical development. (more…)
Author Interviews, Autism, JAMA / 03.11.2014

dr_stefan_hansenMedicalResearch.com Interview with: Stefan Nygaard Hansen PhD Student, MSc Stat Section for Biostatistics Department of Public Health Aarhus University Denmark Medical Research: What are the main findings of the study? Response: The main finding of our study is that 60% of the observed increase in autism prevalence among children born 1980-1991 in Denmark can be explained by changes in the way diagnoses are established and changes in the subsequent registration to national health registries. In 1994, the diagnostic criteria used by clinicians to establish psychiatric diagnoses was changed. This meant the recognition of autism as a spectrum of disorders but it also meant changes in the specific symptoms that form the basis of the autism diagnosis. In 1995, the national health registries in Denmark, which are often used in Danish health research, began to also include diagnoses given in connection with outpatient consultations whereas before 1995 only diagnoses given in connection with hospitalization was reported to the registries. This could mean that we after 1995 see more of the mild autism diagnoses since they may not require hospitalization. (more…)
Author Interviews, Autism, General Medicine, OBGYNE / 26.09.2014

Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638MedicalResearch.com Interview with: Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638 MedicalResearch: What are the main findings of the study? Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing.  Mothers of children with autism also had lower average iron intake. (more…)
Author Interviews, Autism / 12.09.2014

Anilkumar Pillai, Ph.D. Associate Professor Department of Psychiatry Medical College of Georgia Georgia Regents University (Formerly Georgia Health Sciences University)MedicalResearch.com: Interview with: Anilkumar Pillai, Ph.D. Associate Professor, Department of Psychiatry Medical College of Georgia, Georgia Regents University (Formerly Georgia Health Sciences University) Medical Research: What are the main findings of the study? Dr. Pillai: GABA receptors are responsible for binding GABA, the main inhibitory neurotransmitter in the human brain. Recent studies have indicated a potential role for alterations in GABAA receptors in the pathophysiology of Autism Spectrum Disorder (ASD). However, the mechanism of regulation of GABAA receptor in Autism Spectrum Disorder is not known. Our study shows that GABAA levels are altered at the protein level, but not at the mRNA level in the middle frontal gyrus of Autism Spectrum Disorder subjects. Our study also finds that Synoviolin 1 (SYVN1) plays a critical role as an E3 ligase in GABAAα1 degradation. SYVN1 has been previously determined to function as a removal system of inappropriately folded or unfolded proteins from the ER to the cytosol of the cell for degradation. Our study ultimately provides a mechanism for GABAAα1 deficits in Autism Spectrum Disorder subjects and possible new treatment strategies to reverse deficits seen in ASD and other related disorders. (more…)
Author Interviews, Autism, Lancet, Mental Health Research / 26.06.2014

Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UKMedicalResearch.com Interview with: Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UK MedicalResearch.com: What are the main findings of the study? Dr. Cassidy: We found that adults with late diagnosis of Asperger Syndrome (31 years on average), were at significantly higher risk of contemplating suicide during their lifetime (66%) than those from the general UK population (17%), and a sample of patients with Psychosis (59%). We also found that adults diagnosed with Asperger Syndrome with a history of depression, were significantly more likely to experience suicidal thoughts, and suicide plans or attempts, than those with Asperger Syndrome without a history of depression.  A higher level of autistic traits was also a significant risk factor for having planned or attempted suicide. (more…)
Author Interviews, Autism, JAMA, Johns Hopkins / 22.04.2014

Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205MedicalResearch.com Interview with: Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Li-Ching Lee: This population-based case-control study in young children provides evidence that prenatal selective serotonin reuptake inhibitor (SSRI) use may be a risk factor for autism and other developmental delays (DD). Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with autism spectrum disorder (ASD) relative to children with typical development; the strongest association occurred with first-trimester exposure. Exposure was also elevated among boys with DD and was strongest in the third trimester. (more…)
Author Interviews, Autism, JAMA / 10.04.2014

Bradley S. Peterson, MD Director of the Center for Developmental Neuropsychiatry Director of the Center for Developmental Neuropsychiatry, New York State Psychiatric Institute Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry, Columbia University, NYMedicalResearch.com Interview with: Bradley S. Peterson, MD Director of the Center for Developmental Neuropsychiatry Director of the Center for Developmental Neuropsychiatry, New York State Psychiatric Institute Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry, Columbia University, NY MedicalResearch.com: What are the main findings of the study? Dr. Peterson: We detected the presence of lactate in the brains of 13% of 75 participants who had ASD (Autism Spectrum Disorder), compared with 1% of the brains of 96 typically developing control participants. The presence of lactate was especially more common in adults who have ASD. Lactate is a product of anaerobic metabolism, which generally should not occur in healthy, living brains under normal circumstances. The presence of lactate in the brains of persons with Autism Spectrum Disorder therefore suggests the presence of deficient production of energy stores by a component of brain cells called “mitochondria”. We detected lactate most commonly in the cingulate gyrus, a region that supports the higher-order control of thought, emotion, and behavior, and that has been implicated previously in Autism Spectrum Disorder. (more…)
Autism, Genetic Research, NEJM, UCSD / 26.03.2014

MedicalResearch.com Interview with: Dr. Erik Courchesne PhD Professor, Department of Neurosciences UC San Diego School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Courchesne: “Building a baby’s brain during pregnancy involves creating a cortex that contains six layers,” Courchesne said. “We discovered focal patches of disrupted development of these cortical layers in the majority of children with autism.” The authors created the first three-dimensional model visualizing brain locations where patches of cortex had failed to develop the normal cell-layering pattern. The study found that in the brains of children with autism key genetic markers were absent in brain cells in multiple layers. “This defect,” Courchesne said, “indicates that the crucial early developmental step of creating six distinct layers with specific types of brain cells – something that begins in prenatal life – had been disrupted.”  The study gives clear and direct new evidence that autism begins during pregnancy. (more…)
Author Interviews, Autism, Case Western, Cleveland Clinic / 01.02.2014

Roberto Fernández Galán, PhD Department of Neurosciences, School of Medicine Case Western Reserve University Cleveland, OH, USAMedicalResearch.com Interview with: Roberto Fernández Galán, PhD Department of Neurosciences, School of Medicine Case Western Reserve University Cleveland, OH, USA MedicalResearch.com: What are the main findings of the study? Dr. Galán: The main finding is that autistic brains create more information at rest than non-autistic brains. This is consistent with the classical view on autism as withdrawal into self. It is also consistent with a recent theory on autism, the “Intense World Theory”, which claims that autism results from hyper-functioning neural circuitry, leading to a state of excessive arousal. From both perspectives, the classical and the IWT, communication and social deficits associated with autism result from having a more intense inner life and a higher level of introspection. (more…)
ADHD, Author Interviews, Autism / 29.01.2014

Bennett L. Leventhal, MD Nathan S. Kline Institue for Psychiatric Research 140 Old Orangeburg Road, Building 35 Orangeburg, NY 10962MedicalResearch.com Interview with: Bennett L. Leventhal, MD Nathan S. Kline Institue for Psychiatric Research 140 Old Orangeburg Road, Building 35 Orangeburg, NY 10962 MedicalResearch.com:  What are the main findings of the study? Dr. Leventhal: In the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM5) released in May 2013, changes include major alterations in criteria for developmental disorders, in particular, the DSMIV diagnostic criteria for Pervasive Developmental Disorder (PDD), including elimination of subtypes found in DSMIV such as Asperger Disorder and PDD NOS. Additionally, DSM 5 adds a new diagnostic category, Social Communication Disorder (SCD): individuals with SCD have difficulties similar to ASD but these problems are solely restricted to the realm of social communication and do not include the restrictive and repetitive behaviors found in ASD. (more…)
Author Interviews, Autism / 07.01.2014

Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern CaliforniaMedicalResearch.com Interview with Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern California MedicalResearch.com: What are the main findings of the study? Dr. Croen: Researchers found that hospital-diagnosed maternal bacterial infections during pregnancy were associated with an increased risk of autism spectrum disorders (ASD) in children. While infections are fairly common in pregnant women, this study only found increased risks in cases of bacterial infections. Women with bacterial infections diagnosed during a hospitalization (including of the genitals, urinary tract and amniotic fluid) had a 58 percent greater risk of having a child with ASD. Also of note, bacterial infections diagnosed during a hospitalization in the second trimester, while not very common in any of the mothers studied, were associated with children having more than a three-fold increased risk of developing ASD. These findings resulted from a study of 407 children with autism and 2,075 matched children who did not have autism. The study included infants born between January 1995 and June 1999 who remained members of the Kaiser Permanente health plan for at least two years following birth. (more…)
Author Interviews, Autism, OBGYNE / 01.12.2013

MedicalResearch.com Interview with: Jakob Christensen Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; Merete Juul Sørensen Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Denmark MedicalResearch.com: What are the main findings of the study? Answer: We found that the risk of autism spectrum disorder was increased by 50% in children of mothers who took antidepressants during pregnancy. However, when we controlled for other factors related to the medication, by comparing with children of mothers with a diagnosis of depression or with un-exposed siblings, the risk was smaller and not significantly increased. (more…)
Author Interviews, Autism, McGill, Pediatrics / 25.11.2013

Dr. Michael Shevell Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health CentreMedicalResearch.com Interview Dr. Michael Shevell Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre MedicalResearch.com: What are the main findings of the study? Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity. (more…)
Author Interviews, Autism, Genetic Research / 30.10.2013

Linda Brzustowicz, M.D. Professor and Chair Department of Genetics Rutgers University Piscataway, NJ 08854MedicalResearch.com Interview with: Linda Brzustowicz, M.D. Professor and Chair Department of Genetics Rutgers University,Piscataway, NJ 08854 MedicalResearch.com: What are the main findings of the study? Dr. Brzustowicz: The objective of this study was to search for locations in the human genome that impact language ability in individuals with autism as well as in their family members without autism.  To do this, we recruited families with an individual with autism and at least one other family member without autism but with a language learning impairment.  We identified two locations in the human genome that are linked to language ability in these families.  Importantly, these locations do not appear to be specific to language impairment in the individuals with autism, but are related to language ability in other family members as well.  This suggests that while individuals with autism may have new, or de novo, genetic variations that are important for risk of illness, they may also carry inherited genetic variation that influence the expression of their illness.  The effects of these inherited variants can also be seen in the language performance of family members without autism. (more…)
Author Interviews, Autism, General Medicine, JAMA / 20.08.2013

MedicalResearch.com:  Interview with: Therese Koops Grønborg PhD student/ph.d.-studerende, MSc Section of Biostatistics/Sektion for Biostatistisk Department of Public Health/Institut for Folkesundhed Aarhus University Bartholins Allé 2, DK-8000 Aarhus C, Denmark MedicalResearch.com: What are the main findings of the study? Answer: There are three important findings in our study. We estimated a population-based Autism Spectrum Disorder (ASD) sibling recurrence risk relative to the background population and found an almost seven-fold increase. While this indeed is an increased risk, it is also lower than what other recent studies have suggested. We also compared the relative recurrence risk for full and maternal/paternal half siblings and found a lower relative recurrence risk in half siblings than in full siblings, which supports the genetic pathway to ASD. The recurrence risk for maternal half siblings is still higher than for the background population suggesting that factors unique to the mother, such as the intrauterine environment and perinatal history, may contribute to ASD. Last, but not least, we estimated the time trends in the relative recurrence risk. While the ASD prevalence has been increasing for several years, we found no time trends in the relative recurrence risk, suggesting that the factors contributing to the risk for ASDs recurrence in siblings (perhaps a combination of genes and environment) have not changed over time. (more…)