Longitudinal Analysis of Sleep Spindle Maturation from Childhood through Late Adolescence

Sleep spindles are intermittent bursts of 11-15 Hz EEG waves that occur during non-rapid eye movement sleep. Spindles are believed to help maintain sleep and to play a role in sleep-dependent memory consolidation. Here we applied an automated sleep spindle detection program to our large longitudinal sleep EEG dataset (98 human subjects, 6-18 years old, >2000 uninterrupted nights) to evaluate maturational trends in spindle wave frequency, density, amplitude, and duration. This large dataset enabled us to apply nonlinear as well as linear age models, thereby extending the findings of prior cross-sectional studies that used linear models. We found that spindle wave frequency increased with remarkable linearity across the age range. Central spindle density increased nonlinearly to a peak at age 15.1 years. Central spindle wave amplitude declined in a sigmoidal pattern with the age of fastest decline at 13.5 years. Spindle duration decreased linearly with age. Of the four measures, only spindle amplitude showed a sex difference in dynamics such that the age of most rapid decline in females preceded that in males by 1.4 years. This amplitude pattern, including the sex difference in timing, paralleled the maturational pattern for δ (1–4 Hz) wave power. We interpret these age-related changes in spindle characteristics as indicators of maturation of thalamocortical circuits and changes in sleep depth. These robust age-effects could facilitate the search for cognitive-behavioral correlates of spindle waveforms and might also help guide basic research on EEG mechanisms and postnatal brain maturation.SIGNIFICANCE STATEMENT The brain reorganization of adolescence produces massive changes in sleep EEG. These changes include the morphology and abundance of sleep spindles, an EEG marker of non-rapid eye movement sleep believed to reflect offline memory processes and/or protection of the sleep state. We analyzed >2000 nights of longitudinal sleep EEG from 98 subjects (age 6-18 years old) to investigate maturational changes in spindle amplitude, frequency, density, and duration. The large dataset enabled us to detect nonlinear as well as linear age changes. All measures showed robust age effects that we hypothesize reflect the maturation of thalamocortical circuits and decreasing sleep depth. These findings could guide further research into the cognitive-behavioral correlates of sleep spindles and their underlying brain mechanisms.     

Psychiatric Symptoms and Psychosocial Difficulties in Young Adults with Autistic Traits

A screening version of the social responsiveness scale (SRS) was administered to 1,847 university students to identify a subgroup reporting significantly greater autism traits relative to their peers (High SRS group). A group reporting minimal autism traits was also identified (Low SRS group) matched for age, gender, and attentional difficulties. We administered the Behavioral Assessment System for Children—2nd edition (BASC-2), a comprehensive questionnaire designed to assess psychiatric symptoms and personality characteristics, to both groups. The high SRS group reported significantly more difficulties across the majority of areas, including depression/anxiety, interpersonal relationships, and personal adjustment. Thus, young adults reporting a greater degree of autistic traits also reported greater psychiatric difficulties across a wide psychosocial range.     

Autistic Symptoms and Social Functioning in Psychosis: A Network Approach

Psychotic and autistic symptoms are related to social functioning in individuals with psychotic disorders (PD). The present study used a network approach to (1) evaluate the interactions between autistic symptoms, psychotic symptoms, and social functioning, and (2) investigate whether relations are similar in individuals with and without PD. We estimated an undirected network model in a sample of 504 PD, 572 familial risk for psychosis (FR), and 337 typical comparisons (TC), with a mean age of 34.9 years. Symptoms were assessed with the Autism Spectrum Quotient (AQ; 5 nodes) and the Community Assessment of Psychic Experiences (CAPE; 9 nodes). Social functioning was measured with the Social Functioning Scale (SFS; 7 nodes). We identified statistically significant differences between the FR and PD samples in global strength (P < .001) and network structure (P < .001). Our results show autistic symptoms (social interaction nodes) are negatively and more closely related to social functioning (withdrawal, interpersonal behavior) than psychotic symptoms. More and stronger connections between nodes were observed for the PD network than for FR and TC networks, while the latter 2 were similar in density (P = .11) and network structure (P = .19). The most central items in strength for PD were bizarre experiences, social skills, and paranoia. In conclusion, specific autistic symptoms are negatively associated with social functioning across the psychosis spectrum, but in the PD network symptoms may reinforce each other more easily. These findings emphasize the need for increased clinical awareness of comorbid autistic symptoms in psychotic individuals.     

Mood and Anxiety Symptoms in Psychiatric Inpatients with Autism Spectrum Disorder and Depression

Recent reports suggest that individuals with autism spectrum disorders (ASD) may experience depression at a high frequency, yet few published studies address this issue, especially among adults. In the current investigation, we reviewed features of depression and comorbid traits among depressed inpatients with intellectual disabilities (ID) as a function of ASD. A retrospective chart review was performed for 53 inpatients meeting criteria for depression (13 individuals with ASD and ID and 40 matched individuals with ID but without ASD), all of whom had received a diagnosis of depression at the time of discharge from a specialty psychiatric unit for adults with ID. The depression diagnoses were based on a comprehensive clinical assessment; specific mood and anxiety symptoms were reported by informants at the time of intake using the Mood and Anxiety Semi-Structured (MASS) Interview for Patients with Intellectual Disabilities (Charlot, Deutsch, Hunt, Fletcher, & McIlvane, 2007 Charlot, L., Deutsch, C., Hunt, A., Fletcher, K. and McIlvane, W. 2007. Validation of the Mood and Anxiety Semi-Structured (MASS) Interview for Patients with Intellectual Disabilities. Journal of Intellectual Disabilities Research, 51: 821–834. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Overall, few qualitative differences were detected between the 2 groups. Both depressed inpatient groups had high rates of comorbid anxiety disorders as well as externalizing behaviors. Inpatients with ASD had a total of 2 more symptoms (out of 29 possible symptom items) than their depressed peers without an ASD diagnosis (mean scores of 12.23 and 9.85, respectively). Anxiety disorders were reported in 62% of individuals with ASD and 38% of those without ASD. Antipsychotic medication was prevalent among the patients with ASD and depression. Over 80% of the inpatients with ASD and depression, compared with 49% of the non-ASD group, were treated with these medications.     

Early Symptoms of Autistic Children and Its Diagnostic Significance

Abstract. In order to make a checklist for the early diagnosis of autism, the abnormalities of mental development before the age of two were examined retrospectively in autistic children. Additionally, the correlation between these early symptoms and the prognosis of autistic children were investigated. The subjects were 85 autistic children, 64 mentally retarded children and 150 normal children. The parents of these children were interviewed by child psychiatrists based on original questionnaires. The 27 early symptoms indicating disorders in personal relations, perception and sleeping as well as the setback course were found in autistic children. The onset ages of imitating others, pointing at objects and saying Yes were retarded in the poorly developed group as compared with the highly developed group.     

Parent,teacher and self-reports as predictors of signs of disturbance in adolescents: whose information carries the most weight?

We evaluated the ability of parents, teachers and self-reports to predict signs of maladjustment in 353 11- to 14-year-olds from the general population, over a 4-year time interval. Odds ratios were computed in order to test the ability of problem scales to predict later mental health referral and measures of parents’ and children's own perceptions of the existence of major problems. Each informant made its own unique and indispensable contribution to the prediction of signs of maladjustment. Although teachers are often perceived as less able to assess internalizing problems than mothers and the children themselves, the present study showed that teachers’ evaluations of internalizing problems are highly relevant if we take their ability to predict the subject's own perceptions of having problems as the criterion.     

Plasma Cyclic AMP Level in Psychiatric Diseases of Childhood

Abstract: Determinations were made of the plasma cyclic AMP level to examine its relationship with hyperkinesis (Werry-Weiss-Peters Activity Scale, WWPAS) and other features of mental disorders in 80 children, of whom 21 had early infantile autism, 15 hyperkinetic mental retardation, 12 minimal brain dysfunction and 32 Down's syndrome. In autistic and hyperkinetic mentally retarded children, the plasma cyclic AMP levels were higher than in normal children and were positively correlated with the WWPAS score. In children with minimal brain dysfunction, the plasma cyclic AMP level was significantly lower than in normal children and was not correlated with the WWPAS score. In children with Down's syndrome, the plasma cyclic AMP level was somewhat higher than in normal children.     

Autism after Adolescence: Population-based 13- to 22-year Follow-up Study of 120 Individuals with Autism Diagnosed in Childhood

Background: Prospective population-based follow-up study of 120 individuals with autism followed from childhood to adulthood. Methods: Individuals with autism, diagnosed in childhood, were followed prospectively for a period of 13–22 years and re-evaluated at ages 17–40 years. The instruments used at follow-up were the DISCO, WAIS-R, WISC-III, Vineland Adaptive Behavior Scales, psychiatric-medical examination and GAF-scale. A set of criteria was used for the classification of outcomes, taking into consideration employment, higher education/vocational training, independent living and peer relations. Results: Six of the 120 (5%) had died at the time of follow-up, and six declined participation. Overall outcome was poor in 78% of cases. Only four individuals were independent albeit leading fairly isolated lives. Childhood IQ-level was positively correlated with better adult outcome, as was the existence of some communicative phrase speech at age six years. Conclusions: Children with autism as diagnosed in the 1960s, 1970s, and 1980s may have an even worse psychosocial outcome than previously believed.