An investigation into the effects of different types of exercise on the maintenance of approach motivation levels

BackgroundThis study looked to investigate the interaction between exercise and approach motivation (AM) levels in a non-clinical sample as a first step towards investigating the impact of acute exercise upon hypomanic states within Bipolar Disorder. The Behavioural Activation System (BAS) dysregulation theory proposes that AM levels in individuals with Bipolar Disorder, are hyper-reactive to relevant cues and prone to fluctuation such that excessive levels underpin hypomania/mania. We hypothesise that exercise may interact with high AM levels to further increase AM levels in both the general population and individuals with BD, with this effect being exacerbated in the latter group. As an initial test of this theory we explore the impact of moderate and vigorous exercise and sedentary activity upon AM in an unselected student sample. We also tested the extent to which hypomania vulnerability predicts the impact of exercise.MethodParticipants were recruited from a University student population. After completing a measure of hypomanic personality traits, 61 participants completed a task designed to induce higher levels of AM before taking part in one of three 15 min activities (sedentary, moderate exercise or vigorous exercise). AM levels as well as variables relevant to hypomanic symptoms were measured prior to and post AM induction, at 5 min intervals during the activities and twice during a recovery period.ResultsVigorous exercise significantly increased individuals' AM levels in comparison to moderate or no exercise. No association was found between hypomania vulnerability and exercise impact.ConclusionsThese results provide a first step in investigating the possible risks associated with engaging in different intensities of exercise during a hypomanic episode. Any recommendations within this study should however be taken in light of the limitations identified. Further research replicating these results with a larger sample and among individuals with Bipolar Disorder is recommended.     

Oxytocin in the regulation of social behaviours in medial amygdala‐lesioned mice via the inhibition of the extracellular signal‐regulated kinase signalling pathway

The neuropeptide oxytocin (OXT) has been implicated in the pathophysiology of behavioural deficits among patients with autism spectrum disorder (ASD). However, the molecular mechanisms underlying its role in ASD remain unclear. In the present study, a murine model with ASD‐like phenotypes was induced by intra‐medial amygdala injection of N‐methyl‐d ‐aspartate, and it was used to investigate the role of OXT in behaviour regulation. Behavioural tests were performed to verify the ASD‐like phenotypes of N‐methyl‐d ‐aspartate‐treated mice, and the results showed that mice with bilateral medial amygdala lesions presented significant behavioural deficits, including impaired learning and memory and increased anxiety and depression. We also observed a notably decreased level of OXT in both the plasma and the hypothalamus of medial amygdala‐lesioned mice, and the extracellular signal‐regulated kinase (ERK) was activated. Further studies demonstrated that the administration of OXT alleviated ASD‐like symptoms and significantly inhibited phosphorylation of ERK; the inhibitory effect was similar to that of U0126, an ERK signalling inhibitor. In addition, OXT administration modulated the expression of downstream proteins of the ERK signalling pathway, such as cyclic adenosine monophosphate response element binding and c‐fos. Taken together, our data indicate that OXT plays an important role in ameliorating behavioural deficits in an ASD‐like mouse model, which was mediated by inhibiting the ERK signalling pathway and its downstream proteins.     

The diffusion of autism spectrum disorder in Costa Rica: Evidence of information spread or environmental effects?

In the U.S., children with autism spectrum disorder (ASD) have been found to live in spatial clusters. Studies have suggested that the clustering is caused by social or environmental factors, but determining the cause of the clustering is difficult in the U.S. setting because of unmeasured variation in healthcare access and diagnostic practices. The present study explores the diffusion of ASD in a small setting in which the diagnosis is not widely publicised and there is no variation in healthcare access or diagnostic practices. Costa Rica provides universal healthcare and only has one diagnosing clinic for young children, and the diagnosis is relatively new and little known among clinicians and parents. In addition, the potential for mercury exposure from the source that has been associated with ASD is absent, and areas with high levels of air pollution are spatially concentrated. Focusing on all young children who underwent an ASD assessment from 2010 to 2013, we identify spatial clusters that suggest a mechanism that does not depend on information about ASD, healthcare access, diagnostic practices, or environmental toxicants. These findings provide details of the “contextual drivers” of the increasing worldwide prevalence of ASD.     

儿童孤独症谱系障碍早期筛查管理模式研究

目的通过三级网络进行早期筛查早期诊断儿童孤独症谱系障碍(ASD)的管理模式研究,探讨ASD早期发现的网络筛查程序及管理流程,为ASD儿童获得早期干预提供有利的条件。方法成立市级ASD早期诊断管理中心,建立基层社区筛查一级网络及管理流程,进行社区筛查管理技术的指导及培训,再结合二、三级的筛查与诊断给予确诊。结果 1)社区一级网络ASD初筛率由2013年的20.19%上升到2014年的33.68%,呈逐年提高趋势,阳性率维持在4‰~6.0‰;确诊率由0.41‰上升到0.95‰。2)ASD早期诊断中心2年干预疑似患儿38例。结论三级网络ASD早期筛查的管理模式提高了社区儿保医生对ASD的初筛率,有利于ASD儿童的早期发现,为ASD儿童早期干预提供了最佳时期,是切实可行的ASD早期筛查管理模式。     

注意缺陷多动障碍共患数学学习困难儿童韦氏儿童智力结构特征

目的探讨合并数学困难(mathematical difficulties,MD)的注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童在韦氏儿童智力量表第四版(Wechsler Intelligence Scale for Children-The Fourth Vision,WISC-Ⅳ)中的智力结构特征。方法选取根据美国《精神障碍诊断和统计手册第四版》(Diagnostic and Statistical Manual,DSM-Ⅳ)诊断标准确诊为ADHD且数学成绩低于同年级P10、语文成绩不低于同年级P50的儿童30名,并按性别、年龄匹配抽取确诊为ADHD且语文、数学成绩不低于同年级P25的30名作为对照组。使用WISC-Ⅳ对两组儿童的智力结构特点进行比较。结果研究组儿童总智商及四指数均低于对照组儿童(P0.05),两组儿童在字母-数字排序、背数、译码、矩阵推理、积木、理解等分测验的差异有统计学意义(P0.05)。结论 WISC-Ⅳ可以全面评估儿童的一般认知功能,MD-ADHD儿童有独特认知特点,应根据与数学能力相关的认知缺陷进行个体化的科学干预。     

95例孤独症儿童血串联质谱检测的分析报告

目的应用串联质谱(tandem mass spectrometry,MS/MS)技术进行孤独症谱系障碍(autism spectrum disorder,ASD)儿童的遗传代谢病(inborn errors of metabolism,IEM)筛查,了解ASD患儿的高发IEM病种,并探讨IEM与儿童ASD之间的关系。方法利用MS/MS技术对2010年11月-2013年12月于复旦大学附属儿科医院儿童保健科门诊就诊、根据DSM-Ⅳ诊断标准确诊的95名ASD患儿的血液样本进行IEM筛查。结果 1名(1.95%)患儿存在苯丙酮尿症,1名(1.95%)患儿戊二酸血症-II型不能除外,其他患儿(96.1%)均不存在本研究所涉及的IEM。结论本研究为晚诊断的苯丙酮尿症与ASD之间的关联提供了案例支持,苯丙酮尿症可能是儿童ASD的共患病之一;戊二酸血症-II型与ASD之间可能存在一定联系。对于IEM高危患儿、特别是生后未行新生儿筛查的ASD患儿,及时地进行IEM筛查对于全面诊断和治疗ASD有着重要意义。     

孤独谱系障碍患儿父母压力和家庭功能的特点及相关研究

目的探讨孤独谱系障碍(autism spectrum disorder,ASD)患儿父母压力和家庭功能的相关性,对改善家庭困境及患儿预后提供参考依据。方法采用父母压力指数量表(Parenting Stress Index,PSI)、家庭功能评定量表(Family Assessment Device,FAD)对ASD患儿父母进行评定。结果 1)不同性别患儿父母在接受度、要求、角色限制差异有统计学意义(P0.05);不同学龄期患儿父母在注意缺陷/多动、适应性、心境、接受度、要求、依恋以及压力总分差异有统计学意义(P0.05),低收入家庭与高收入家庭在多个维度间差异有统计学意义(P0.05);2)学龄前患儿父母的问题解决能力强于学龄期患儿父母(P0.05);较高收入组在问题解决、角色、情感反应、行为控制、总体功能方面明显优于较低收入组(P0.01);3)父母压力与父母亲受教育年限及家庭收入呈负相关,与患儿年龄及家庭功能量表的得分呈正相关;父母压力主要受母亲受教育年限、家庭功能中的行为控制以及总体功能影响。结论家庭在养育ASD患儿时存在一定的压力,养育男性患儿承受的压力更大,同时家庭收入也在一定程度上影响父母压力及家庭功能;并且家庭功能越差父母承受的压力越大。     

代谢异常在单纯性肥胖儿童脂肪肝中的作用

目的：探讨代谢异常在单纯性肥胖儿童脂肪肝发生中的作用。方法2012年7月至2013年7月在武警陕西省总队医院小儿内分泌专科门诊确诊的158例单纯性肥胖儿童,根据研究对象是否合并代谢异常,分为代谢异常组96例及非代谢异常组62例。对所有研究对象测量身高、体重、腰围、臀围及血压。空腹12小时后,进行肝脏B超,并采集空腹血,检测血脂全套、转氨酶、血糖。结果肥胖代谢异常组身体质量指数、腰臀比与非代谢异常组相比,均具有显著差异（ t值分别为6．22和4．14,均P＜0．05）;腰围身高比与非代谢异常组相比,差异无统计学意义（t＝2．00,P＞0．05）。代谢异常组儿童甘油三酯,谷草转氨酶及谷丙转氨酶的水平均显著高于非代谢异常儿童（t值分别为5．42、7．34和9．56,均P＜0．05）。肥胖儿童仅合并1项代谢异常时脂肪肝发病率为44．44％,当合并4项代谢异常时,发病率高达85．71％,不同程度代谢异常组儿童脂肪肝发病率之间比较具有统计学差异（χ2＝14．32,P＜0．05）。结论肥胖儿童体内代谢异常越严重,脂肪肝发病越高,脂肪肝可能是肥胖儿童体内代谢紊乱达到一定程度的结果。