17º CONGRESSO BRASILEIRO DE NEUROLOGIA INFANTIL

Dados do Trabalho


Título

STUDY OF FACTORS ASSOCIATED WITH THE LEVEL OF AUTISM SPECTRUM DISORDER IN A CLINICAL SAMPLE

Introdução

Autism Spectrum Disorder (ASD) is a heterogeneous Neurodevelopmental Disorder that causes an impairment of social communication and repetitive behaviors. It can be divided into levels 1 to 3, depending the level of support required. Language and Cognitive Development are the most determining factors to ASD level. However, others situations can interfere with the level of ASD, such as perinatal risk factors, gender, delay or language regression, self-injury, neurological conditions and psychiatric behaviors.

Objetivo

To analyze how these factors can be related to the ASD.

Métodos

This is a cross-sectional analytical observational study of 470 individuals aged 1 to 18 years diagnosed with ASD in outpatient follow-up.

Resultados

There was a predominance of males in a 4:1 ratio and ASD level 1 in 46% of the sample. There was no association between gender and level of commitment. Among perinatal risk factors, prematurity was the most frequent and is associated with ASD level 3, with a prevalence 2.6 times higher than in the rest of the sample. 12% presented language regression and 70% language delay, being more frequent in levels 2 and 3. Selinjury behaviors was present in 11% of the sample, being more common also in ASD level 3. Betwen the psychiatric disorders symptoms, the Attention Deficit Hyperactivity Disorder were more frequent in ASD level 1, as well as depressive symptoms and suicidal ideation. There was no correlation betwen anxiety symptoms end ASD level. Sleep Disorders were reported in 15% of the sample, with no relation to ASD level. Apraxia of Speech was more common in patients with ASD level 3. Epilepsy was present in 5% of the sample, with a prevalence 5 times higher in ASD level 3 and the presence of an abnormal Electroencephalogram, with or without Epilepsy had a prevalence 1.9 times higher in ASD level 3.

Conclusões

ASD is a heterogeneous disorder and specific factors can interfere with its level of impairment and life quality of these individuals.

Palavras chave

Autism Spectrum Disorder and comorbidities; risk factors in Autism Spectrum Disorder; levels of Autism Spectrum Disorder;

Referências (se houver)

AL BACKER, N.B. Developmental regression in autismo spectrum disorder. Sudan J Paediatr, v.15, n.1. p. 21- 26, 2015.

ALLISON K. M. et al.. Differential diagnosis of apraxia of speech in children and adults: a scoping review. Journal of Speech, Language, and Hearing Research, v. 63, p. 2952–2994, 2020.

ANDREADOU, M.T. et al.. Association of assisted reproductive technology with autism spectrum disorder in the offspring: an updated systematic review and meta‑analysis. European Journal of Pediatrics, v. 180, p. 2741–2755, 2021.

APA – AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and Statistical Manual of Mental Disorders. 4 ed Texto Revisado. (DSM – IV - TR). Arlington: American Psychiatric Publishing, 1994.

APA – AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and Statistical Manual of Mental Disorders. 5 ed. (DSM – 5). Arlington: American Psychiatric Publishing, 2013.

ARIAS-CARRION, A.; POPPEL, E. Dopamine, Learning and Reward-Seeking Behavior. Acta Neurobiol. EXP., Poland, v.67, v. 67: 481-488, 2007.

ASPERGER H. Die ‘Autistischen Psychopathen’ im Kindesalter. Arch Psychiatr, v. 117, p. 76–136, 1944.

BERG, A.T.; PLIOPLYS, S.; TUCHMAN, R. Risk and Correlates of Autism Spectrum Disorder in Children with Epilepsy: a Community-Based Study. J Child Neurol, Rochester, v. 26, p. 540–547, 2011.

BRASIL. Decreto-lei n. 12.764, de 27 de dezembro de 2012. Diário Oficial da República Federativa do Brasil, Brasília, 2012.

CDC – CENTERS FOR DISEASE CONTROL. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network. MMWR - Morbidity And Mortality Weekly Report, v.63, 2014.

CDC – CENTERS FOR DISEASE CONTROL. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network. MMWR - Morbidity And Mortality Weekly Report, v.69, 2020.

CHEN, L.W. et al.. Early neurodevelopmental trajectories for autism spectrum disorder in children born very preterm. Pediatrics, v. 146, n. 4, 2020.

CZECH, H. Hans Asperger, national socialism, and “race hygiene” in nazi-era Vienna. Molecular Autism, v. 9, p. 1–43, 2018.

DANIELSSON, S. et al.. Epilepsy in young adults with autism: a prospective population-based follow-up study of 120 individuals diagnosed in childhood. Epilepsia, v. 46, n.6, p. 918-923, 2005.

DE LA TORRE-UBIETA, L. et al.. Advancing the understanding of autism disease mechanisms through genetics. Nat Med, v.22, p. 11-19, 2016.

DE-IA-IGLESIA, M. OLIVAR, J. Risk factors for depression in children and adolescents with high functioning autism spectrum disorder. The Scientific World Journal, v.1, 2015.

DEAN, DC; FREEMAN, A; LAINHART J. The development of the social brain in baby siblings of children with autism. Curr Opin Psychiatry, v. 33, n.2, p. 110–116, 2020.

DONVAN, J.; ZUCKER, C. Outra sintonia : a história do autismo. Tradução de: LUIZ A. DE ARAÚJO, 1 ed. São Paulo: Companhia das Letras, 2017. Título original : The Story of Autism, 2017.

ELDER, J.H. et al.. Clinical impact of early diagnosis of autism on the prognosis and parent–child relationships. Psychology Research and Behavior Management, v.1; 2017.

ENDRES, R.G. et al.. The broader autism phenotype in parents of children with Autism Spectrum Disorder. Psicologia: Teoria e Pesquisa, v.31, n. 3, p. 285-292, 2013.

FALCK-YTTER, T. et al.. The Babytwins Study Sweden (BATSS): a multi-method infant twin study of genetic and environmental factors influencing infant brain and behavioral development. Twin Research and Human Genetics v.1, p.1–11, 2021.

FARMER, C.; THURM, A.; GRANT, P. Pharmacotherapy for the Core Symptoms in Autistic Disorder: Current Status of the Research. Drugs, v. 74, n.4, p. 303–314, 2013.

FERNÁNDEZ, I. S. et al.. Should epileptiform discharges be treated? Invited Review:Epilepsia. Epilepsia, v.56, n.10, p. 1492–1504, 2015.

FENOGLIO A.et al.. Social brain circuitry and social cognition in infants born preterm. Journal of Neurodevelopmental Disorders, v. 9, n.27, 2017.

FOUNTAIN, C. et al.. Six developmental trajectories characterize children with autism. Pediatrics, v. 129, n. 5, 2012.

FRIEDMAN L., STERLING A. a review of language, executive function, and intervention in Autism Spectrum disorder. Seminars in speech and language, v. 40, n. 4, 2019.

FRITH, U. Asperger and his syndrome. 1 ed, Cambridge: Cambridge University Press; 1991.

GESCHWIND, D.H. Genetics of Autism Spectrum Disorders. Trends in Cognitive Science, v. 15, p. 409-416, 2011.

GIAMBATTISTA, C. et al.. Subtyping the autism spectrum disorder: comparison of children with high functioning autism and asperger syndrome. Journal of Autism and Developmental Disorders, v.49, p. 138–150, 2019.

GHIRARDI, L. et al.. Familial and genetic associations between autism spectrum disorder and other neurodevelopmental and psychiatric disorders. Journal of Child Psychology and Psychiatry, v.1, p.1-11, 2021.

GOMES, P.T.M, et al.. Autism in Brazil: a systematic review of family challenges and coping strategies. Jornal de Pediatria, v. 91, p. 111-121, 2005.

HIROSAWA, T. et al.. Epileptiform discharges relate to altered functional brain networks in autism spectrum disorders. Brain Communications, v.1, p1-13, 2021.

HOLANDA, N.S. et al.. Screening for autism spectrum disorder in premature subjects hospitalized in a neonatal Intensive Care Unit. Int. J. Environ. Res. Public Health, v. 17, p. 7675, 2020.

HONG, E.; MATSON J.L. Factors associated with restricted, repetitive behaviors and interests and diagnostic severity level ratings in young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, v.1, 2021.

HOOGENHOUT, M.; MALCOLM-SMITH S. Theory of mind predicts severity
level in autismo. Autism, v.4, 2016.

IVANOV, J.H. et al.. Autism spectrum disorder - a complex genetic disorder. Folia Medica, v.57, n.1, p.19-28, 2015.

KANNER, L. Autistic disturbances of affective contact. Nerv Child, v.2, p.217-250, 1943.

KINAST, K. et al.. Genetic and pharmacological manipulation of the serotoninergic system in early life: neurodevelopmental underpinnigs of autism-related behavior. Frontiers in Cellular Neuroscience, v.7, p. 1-17, 2013.

KOHANE, I.S. et al.. the co-morbidity burden of children and young adults with autism spectrum disorders. PLOS ONE, v.7, p. 1-7, 2012.

LEPPA, V.M. et al.. rare inherited and de novo CNVs revel complex contributions to ASD risk in multiplex families. Am J Hum Genetics, v. 1, p. 540-554, 2016.

LOMBARDO, M.V.; MENG-CHUAN, L.; BARON-COHEN, S. Big data approaches to decomposing heterogeneity across the autism spectrum. Mol Psychiatry, v. 24, p. 1435–1450, 2019.

MAHAJAN, R; MOSTOFSKY, S. Neuroimaging endophenotypes in Autism Spectrum Disorder. CNS Spectr, v. 20, n.4, p. 412–426, 2015.

MALONEY, .S.E.; RIEGER, M.A.; DOUGHERTY, J.D. identifying essential cell types and circuits is autism spectrum disorders. Int Ver Neurobiol, v. 113, p. 61-96, 2013.

MAIS, A. et al.. An overview of Autism Spectrum Disorder, heterogeneity and treatment options. Neurosci Bull, v. 33, n. 2, p. 183–193, 2017.

MAZZONE, L.; RUTA, L.; REALE, L. Psychiatric comorbities is asperger syndrome and high funcioning autism: diagnostic challenges. Annals of General Psychiatry, v.11, p. 1-6, 2012.

MEHDIZADEHFAR, V. et al.. Brain connectivity analysis in fathers of children with autism. Cognitive Neurodynamics, v. 1, p. 2-13, 2020.

MORGAN, A.T.; WEBSTER, R. Aetiology of childhood apraxia of speech: a clinical practice update for paediatrician. Journal of Paediatrics and Child Health, v.54, p. 1090-1095, 2018.

NAKAMURA, K. et al.. Brain Serotonin and Dopamine Transporter Bindings in Adults With High-Functioning Autism. Arch Gen Psychiatry, Chicago, v.67, p. 59-68, 2010.

OUSLEY, O.; CERMAK, T. Autism Spectrum Disorder: defining dimensions and subgroups. Curr Dev Disord Rep, v.1, p. 20–28, 2014.

PARDO, C.A.; EBERHARDT, C.G. The neurobiology of autism. Brain Pathol, v. 17, p. 434-447, 2007.

PAULA, C.S, et al.. Brief report: prevalence of pervasive developmental disorder in Brazil: a pilot study. J Autism Dev Disord, v.41, p. 1738–1742, 2011.

PEARSON, N. et al.. Regression in autism spectrum disorder: reconciling findings from retrospective and prospective research. Autism Research, v.1, p. 1-19, 2018.

PERSICO A.M. et al.. The pediatric psychopharmacology of autism spectrum disorder: a systematic review - part i: the past and the present. Progress in Neuropsychopharmacology & Biological Psychiatry, v.110, 2021.

POSAR, A.; VISCONT, P. Update about “minimally verbal” children with autism spectrum disorder. Rev Paul Pediatr, v. 40, p. 1-11, 2020.

POSTORINO, V. et al.. Anxiety disorders and obsessive complsive disorder in individuals with autismo spectrum disorder. Curr PsychiatryRep, v.19, n.12, 2018.
QUTRANJI, L. et al.. Evaluation of the relationship between environmental factors, nutrition, and metabolic changes in children diagnosed with autism in North Cyprus: a case-control study Lubna. . Cureus, v.13, n.8, 2021.

REDDIHOUGH D.S. et al.. Effect of fluoxetine on obsessive-compulsive behaviors in children and adolescents with autism spectrum disorders: a randomized clinical trial. JAMA, v. 322, n. 16, 2019.

REIERSEN, A.M.; TODOROV, A.A. Association between DRD4 genotype and Autistic Symptoms in DSM-IV ADHD. J Can Acad Child Adolesc Psychiatry, Montreal, v. 20, p.15-21, 2011.

RIVARD, M. et al.. The diagnostic trajectory in autism and intellectual disability in Quebec: pathways and parents’ perspective. BMC Pediatrics, v.21, p. 393-402, 2021.

RAO, P.A.; LANDA, R.J. association between severity of behavioral phenotype and comorbids Attention Deficit Hiperactivity Disorder symptoms in children with Autism Spectrum Disorders. Autism, v.18, p. 272-280, 2014.

RICHARDS C. at al. Prevalence of autism spectrum disorder phenomenology in
genetic disorders: a systematic review and meta-analysis. Lancet Psychiatry, p. 1-8, 2015.

ROTHMOND, D.A.; WEICKERT, C.S.; WEBSTER, M.J. Developmental changes in human dopamine neurotransmission: cortical receptors and terminators. BMC Neuroscience, London, v. 13, p. 18-27, 2012.

RYNKEWICZ, A. et al.. An investigation of the ‘female camouflage effects’ in autismo using a computerized ADOS-2 and testo f sex/gender diferences. Molecular Autism, v. 7, n.10, p. 2-8, 2016.

SANDIN S. et al.. Autism and mental retardation among offspring born after In Vitro Fertilization. JAMA, v. 1, p.75-84, 2013.

THIPATHI, P.P., BOZZI, Y. The role of dopaminergic and serotoninergic systems in neurodevelopmental disorders: a focus on epilepsy and seizure susceptibility. Bioimpacts, v.5, p. 97-102, 2015.

TUCHMAN, R.; MOSHE, S.L.; RAPIN, I. convulsing toward the pathophysiology of autism. Brain Devel, v.31, p. 95-103, 2009.

TYE, C. et al.. characterizing the interplay between Autism Spectrum Disorder and comorbid medical conditions: an integrative review. Front Psychiatry, v.9, p. 1-21, 2019.

UNG, D. et al.. clinical caracteristics of high funcioning youth with Autism Spectrum Disorder and anxiety. Neuropsichyatry, v.3, p 2-8, 2013.

VEENSTRA-VANDERWEELE, J.; BLAKELY, R.D. Networking in Autism: leveraging genetic, biomarker and model system findings in the search for new treatments. Neuropsychopharmacology, v. 37, p. 196-212, 2012.

VERHOEFF, M.E. et al.. The bidirectional association between sleep problems and autism spectrum disorder: a population based cohort study. Molecular Autism, v.9, 2018.

VISCIDI, E.W. et al.. Clinical characteristics of children with Autism Spectrum Disorder and co-occuring epilepsy. PLo One, v.8, p. 67797-67808, 2013.

VOINEAGU, I.; YOO, H.J. Current progress and challenges in the search for autism biomarkers. Disease Markers, v.35, p. 55-65, 2013.

VON STEENSEL, F.J.A.; BOGGELS, S.M.; BRUIN, E.I. psychiatric comorbitiy in children with Autism Spectrum Disorder: a comparisson with childrens with ADHD. J. Child Fam Stud, v.22, p. 368-376, 2013.

WING L. Asperger’s syndrome: a clinical account. Psychol Med, v.11, p. 115–296, 1981.

WIGGINS, J.L. et al.. The Impact of Serotonin Transporter Genotype on Default Network Connectivity in Children and Adolescents with Autism Spectrum Disorder. Neuroimage: Clinical, v.2, p. 17-24, 2013.

WU, YE, et al.. Genoma-wide, integrative analysis implicates microRNA dysregulation inautism spectrum disorder. Nat Neurosci, v. 10, p. 119-134, 2016.

YERYS, B.E. et al.. Attention deficit/hyperactivity disoreder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Res, v.2, n.6, 2009.

YUEN, R.K. et al.. Whole-genome sequencing of quartet families with autism spectrum disorder. Nat Medicine, v.21, p. 185-191, 2015.

Fonte de Fomento (se houver)

Declaração de conflito de interesses de TODOS os autores

NÃO HÁ CONFLITOS DE INTERESSE

Área

Outros

Instituições

Universidade Federal do Paraná - Paraná - Brasil

Autores

MARIANE WEHMUTH, Sérgio Antônio Antoniuk