孤独症谱系障碍儿童面部表情识别的认知神经机制

<正>孤独症谱系障碍(autism spectrum disorder,ASD),包括孤独症、阿斯伯格综合征、儿童期瓦解性障碍以及非特定的广泛性发育障碍等[1]。ASD儿童核心症状表现为社会交往障碍、语言交流障碍以及重复刻板行为等。而面部表情识别能力(facial expression recognition,FER)对有效社会交往有着重要作用。因此,探讨ASD儿童面部表情识别的能     

儿童孤独症血浆5-羟色胺的测定

目的 比较孤独症儿童和正常儿童血浆5-羟色胺(5-HT)的浓度,探索5-HT浓度增高和5-HT浓度正常的孤独症儿童各自的临床特点。方法 采用孤独症行为评定量表(ABC)、儿童期孤独症评定量表(CARS)和适应行为评定量表对33例孤独症儿童进行评定,并进行了血浆5-HT检测,以高出正常儿童平均5-HT浓度1.67个标准差的孤独症儿童为5-HT增高组,其他孤独症儿童为5-HT正常组,比较两组孤独症儿童的临床特征。结果 孤独症儿童的ABC得分为72.30±29.91、CARS的得分为41.83±4.05、适应行为评定量表的得分为66.55±12.52。孤独症儿童5-HT浓度为0.77±0.33μmol/L;正常儿童5-HT浓度为0.62±0.18μmol/L,两组经t检验有显著性差异(t=2.23;P=0.03)。5-HT增高的孤独症儿童有9例,5-HT正常的孤独症儿童有24例,两组临床特征比较未发现明显差异。结论 27.3％的孤独症儿童5-HI浓度增高,5-HT增高与5-HT正常的儿童孤独症临床特征相同。孤独症的病因可能是异质性的。     

高功能孤独症患儿胼胝体及额叶体积的磁共振研究

目的探讨高功能孤独症(high functioning autism,HFA)患儿的胼胝体以及额叶体积是否异常。方法对17例6~14岁的HFA患儿(智商≥70)以及16名年龄、性别、智商等与患者组相匹配的健康学龄儿童进行T1加权三维容积磁共振成像。根据改良的Witelson范式将胼胝体划分为五个亚区,采用自编软件计算和比较两组被试胼胝体区及各个亚区的体积,应用个体脑结构地图集(Individual brain atlases using SPM,IBASPM)工具箱计算额叶体积。结果 HFA组与正常对照组相比额叶总体积及左侧额叶体积增大[(193.91±23.23)cm3vs(177.86±18.2)cm3,P=0.04;(96.08±11.89)cm3vs(87.52±9.14)cm3,P=0.03],而右侧额叶、胼胝体总体积及各亚区的体积差异均无统计学意义(P>0.05);HFA组胼胝体前三分之一部的体积与额叶总体积、右侧额叶体积呈正相关(r=0.51,P=0.04;r=0.50,P=0.04);未见HFA组中儿童孤独症评定量表评分与胼胝体及额叶的体积存在相关(P>0.05)。结论 HFA患儿的额叶体积增...     

脑干听觉诱发电位对儿童行为障碍的评估

目的 脑干听觉诱发电位(Brainstem Auditory Evoked Potential ,BAEP)可以从电生理角度评价听觉传导道路各种神经核团的功能状况。同时对于脑干功能的成熟和完善情况也提供信息。有关儿童行为异常的病因至今不清楚或仅仅某一种非特定的脑损伤被推测。方法 通过对11例抽动-秽语综合症、14例多动症及21例智能低下的儿童作BAEP测试,同时以22例正常儿童作为对照,以求寻找其脑损伤的电生理学特征。结果 智能低下组有2例来自下丘的反应波(V波)消失,有1例来自听神经反应波(I波)潜伏期较正常对照组延长智能低下组明显延长,与正常对照组、抽动-秽语综合征组及多动症组比较有显著性差异(P<0. 01)另外,中枢传导时间,代表听神经反应波(I波)到下丘反应波(V波)的传导时间,在正常对照组中最短,而在多动症组中明显延长,与正常对照组、抽动-秽语综合征组及智能低下组比较有显著性差异(P<0 .01)。结论 有多动症和智能低下的儿童中有脑损伤存在的电生理学依据,至少在涉及听觉功能的脑干部分。     

心理引导联合家庭康复训练对自闭症儿童的效果

目的分析心理引导联合家庭康复训练对自闭症(Autism)儿童社会功能及对患者情绪、心理的影响。方法入组研究对象是2019年1月~2020年12月本院82例自闭症患儿,分组依照随机法(每组n=41),对比组接受常规康复治疗,病例组接受心理引导联合家庭康复训练治疗,对比两组儿童适应行为量表(Child Adaptive Behavior Scale,CABS)评分、孤独症行为评定量表(autism behavior checklist,ABC)评分、儿童孤独症评定量表(childhood autism rating scale,CARS)评分、改良婴幼儿孤独症量表(Modified Checklistfor Autismin Toddlers,M-CHAT)评分和家属满意度。结果病例组治疗后CABS评分比对比组高,病例组治疗后ABC评分、CARS评分、M-CHAT评分均低于对比组(P<0.05),病例组家属满意度为95.12%,高于对比组的73.17%(P<0.05)。结论心理引导联合家庭康复训练可有效减轻自闭症患儿孤独感,提高适应行为、社会功能以及家属满意度。     

72例孤独症的系统综合训练对策及效果观察

目的探讨孤独症儿童系统训练对策及效果。方法将符合条件的140例孤独症患儿随机分成两组,研究组共72例,接受为期6个月的系统综合训练,对照组共68例,暂不接受该系统综合训练。然后分别于研究前、6个月末应用孤独症行为量表（ABC）对两组患儿进行效果评估。结果与训练前相比,研究组治疗结束后ABC量表总分及各项得分均降低,其中感觉能力、交往能力、运动能力、语言能力得分前后差异具有非常显著性（P〈0．01）,自理能力项得分前后差异具有显著性（P〈0．05）。结论系统综合训练对孤独症儿童症状的改善是有效的。     

血微量元素与儿童孤独症及症状严重程度的相关性

目的:探讨儿童孤独症患者全血微量元素含量,以及与儿童孤独症症状严重程度的相关性。方法:选取25例儿童孤独症患者作为病例组,30例健康者作为对照组,采用原子吸收分光光度法对被试的全血铜、锌、钙、镁和铁离子水平进行测定;采用儿童孤独症行为量表(AutismBehaviorChecklist,ABC)对病例组的症状进行评估。结果:与对照组相比,病例组的血镁和锌离子含量降低(t=-12.435,P<0.001;t=-11.44,P<0.001),而血铜离子含量增高(t=3.915,P<0.05),差异具有统计学意义。两组的其余血微量元素含量差异不显著。儿童孤独症行为量表的得分与血镁、锌离子含量呈显著负相关(r=-0.813,P<0.001;r=-0.785,P<0.001),与血铜离子含量呈显著正相关(r=0.466,P<0.001)。结论:孤独症患儿症状的严重水平与血镁和锌离子含量降低,血铜离子含量增高有密切关系,血微量元素含量异常可能是诊断儿童孤独症的敏感生物学指标之一。     

伴中央-颞区棘波的良性癫痫患儿认知功能分析

目的 探讨BECCT患儿的认知功能状况。方法 对20例BECCT患儿及20例正常儿童进行事件相关电位P3测定及神经心理测验，比较两组间各认知功能指标的差异。结果BECCT患儿较正常儿VIQ低(P＜0．05)。P3潜伏期延长(P＜0．01)。结论 BECCT患儿存在认知功能障碍，主要为大脑对外界信息的反应速度及综合能力受影响。     

愤怒心理应激大鼠模型的建立及对行为、内分泌免疫的影响

目的　制作愤怒心理应激的动物模型,建立其行为评估体系,观察愤怒应激对大鼠内分泌和免疫系统的影响。方法　采用Megan方法制造模型,将32只雄性Wistar大鼠分为正常对照组、愤怒模型组、孤独对照组3个实验组和1个入侵组,每组8只,记录并分析各实验组大鼠的行为变化,检测血液促肾上腺皮质激素(ACTH)、皮质醇、白细胞介素2 (IL 2)、白细胞介素8 (IL 8)水平,有效评价模型质量。结果　(1)愤怒模型组行为评定总分为(65 88±6 20)分;各行为指标与总分呈中至高度正相关(r=0 363~0 915)。(2)旷场实验中的水平得分、垂直得分及总分,愤怒模型组均高于正常对照组和孤独对照组,孤独对照组也高于正常对照组(均P<0 01)。行为学观察,与正常对照组比较,愤怒模型组中央格停留时间长,修饰次数和修饰时间少,粪便粒数多;孤独对照组中央格停留时间长,修饰次数(P<0 05)和修饰时间少(均P<0 01)。与愤怒模型组比较,孤独对照组中央格停留时间长,修饰次数和修饰时间多,粪便粒数少(均P<0 01 )。( 3 )与正常对照组比较,愤怒模型组血浆ACTH和皮质醇高,IL 2低;孤独对照组ACTH高(P<0 01和P<0 05)。与愤怒模型组比较,孤独对照组IL 2高(P<0 01)。结论　该模型是理想的愤怒心理应激模型,模型评估方法可行性较好;愤怒心理应激能够激活丘脑-垂     

孤独症儿童父母生活质量与睡眠的相关研究

目的探讨宁夏孤独症儿童父母的生活质量与睡眠状况。方法采用生活质量综合评定问卷（GQOLI-74）和匹兹堡睡眠指数（PSQI）对60例孤独症儿童父母及60例正常儿童父母进行对照研究,采用t检验比较两组GQOLI-74和PSQI得分情况,并将GQOLI-74得分和PSQI得分进行相关分析。结果孤独症儿童父母的GQOLI总分及物质生活维度、心理功能维度和社会功能维度的得分均显著低于正常儿童父母;而PSQI得分则显著高于正常儿童父母。孤独症儿童父母总体生活质量及心理功能、社会功能与睡眠质量呈显著负相关。结论孤独症儿童父母的生活质量和睡眠质量均较差,应加强社会支持并积极给予心理援助和治疗。     

Recognition of Faux Pas by Normally Developing Children and Children with Asperger Syndrome or High-Functioning Autism

Most theory of mind (ToM) tests are designed for subjects with a mental age of 4–6 years. There are very few ToM tests for subjects who are older or more able than this. We report a new test of ToM, designed for children 7–11 years old. The task involves recognizing faux pas. Study 1 tested 7–9, and 11-year-old normal children. Results showed that the ability to detect faux pas developed with age and that there was a differential developmental profile between the two sexes (female superiority). Study 2 tested children with Asperger syndrome (AS) or high-functioning autism (HFA), selected for being able to pass traditional 4- to 6-year level (first- and second-order) false belief tests. Results showed that whereas normal 9- to 11-year-old children were skilled at detecting faux pas, children with AS or HFA were impaired on this task. Study 3 reports a refinement in the test, employing control stimuli. This replicated the results from Study 2. Some patients with AS or HFA were able to recognize faux pas but still produced them. Future research should assess faux pas production.     

Reading the mind in the voice: a study with normal adults and adults with Asperger syndrome and high functioning autism

People with high functioning autism (HFA) and Asperger syndrome (AS) have deficits in theory of mind (ToM). Traditional ToM tasks are not sensitive enough to measure ToM deficits in adults, so more subtle ToM tests are needed. One adult level test, the Reading the Mind in the Eyes test has shown that AS and HFA subjects have measurable deficits in the ability to make ToM inferences. Here we introduce a test that extends the above task into the auditory domain and that can be used with adults with IQ Scores in the normal range. We report the use of the test with an adult sample of people with AS/HFA and with two adult control groups. Results suggest that individuals with AS/HFA have difficulty extracting mental state information from vocalizations. These results are consistent with previous results suggesting that people with HFA and AS have difficulties drawing ToM inferences.     

Sleep Patterns of School-Age Children with Asperger Syndrome or High-Functioning Autism

Sleep patterns of 32 school-age children with Asperger syndrome (AS) and high-functioning autism (HFA) were compared to those of 32 typically developing age- and gender-matched children, using parent survey and one week of diary and actigraphic monitoring. Parents of children with AS/HFA more commonly reported that their children had difficulty falling asleep. One week of sleep recording with diary and actigraphy confirmed that children in the AS/HFA group spent a longer time awake in bed before falling asleep than children in the control group, possibly because the children in the AS/HFA group had earlier bedtimes. Other essential aspects of sleep patterns coincided between the groups. The sleep patterns of children with AS and HFA did not differ.     

Defining the Intellectual Profile of Asperger Syndrome: Comparison with High-Functioning Autism

Asperger syndrome (AS) is a disorder of early childhood characterized by autistic social deficits, subtle communication impairment, and excessive isolated interests. There is no history of language delay or of mental retardation. Despite its increasing popularity as a distinct condition, its diagnostic validity remains uncertain. It is still unclear to what extent AS differs from autism with normal intelligence sometimes referred to as high-functioning autism (HFA). However, some reports have suggested that persons with AS possess a distinct profile on tests of intelligence characterized by a high verbal IQ and a low performance IQ, whereas in most cases with HFA, the pattern is reversed. Since few studies have directly compared AS subjects with HFA controls using unmodified diagnostic criteria and standardized measures of assessment, in this report we compared 22 AS subjects with 12 HFA controls, matched on age, sex and level of intelligence. As a group, subjects with AS showed a higher verbal IQ and higher scores on information and vocabulary subtests than those with HFA. However, scores of several AS and HFA subjects showed a mixed pattern. Implications of these findings are discussed in the context of the validity of Asperger Syndrome.     

Brief Report: Cognitive Flexibility and Focused Attention in Children and Adolescents with Asperger Syndrome or High-Functioning Autism as Measured on the Computerized Version of the Wisconsin Card Sorting Test

The aim of the present study was to assess mental flexibility and set maintenance of a group of individuals with Asperger syndrome (AS) or high-functioning autism (HFA) (N = 13; mean age 16,4), as compared with a matched group of typically developing children and adolescents (N = 13; mean age 15,6) on the computerized version of the Wisconsin Card Sorting Test (WCST). The participants in the AS/HFA group performed less well than the controls on all categories of the WCST, but the differences did not reach conventional statistical significance on most categories of the WCST. On the category failure to maintain set, however, the AS/HFA participants performed significantly less well than the controls, suggesting a deficit of focused attention.     

Brief Report: The Impact of Subcortical Band Heterotopia and Associated Complications on the Neuropsychological Functioning of a 13-year-old Child

Motor impairment in children with Asperger syndrome (AS) or high functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14–22 year old HFA/AS. Sixteen HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). The HFA/AS group showed strongest impairments of dynamic balance skills and diadochokinesis. Motor abilities were associated with degree of social withdrawal in the full sample and severity of current autistic symptoms in the HFA/AS group. Similar motor patterns as in younger children were found in the older adolescents. The association of autistic symptoms with motor performance points towards an essential role of motor impairment in autism spectrum disorders.     

Asperger’s syndrome and high-functioning autism: language, motor and cognitive profiles

The objective of this study is to compare the cognitive profile, the motor and language functioning and the psychosocial adaptation of children with Asperger syndrome (AS) and with high-functioning autism (HFA). Subjects were recruited through the department Autism and Developmental Disorders of the Heckscher-Klinikum. To be included in the study, the full-scale-IQ had to be at least 80. Subjects with AS had to have a normal early language development and subjects with HFA a clear delay in language development, as reported by their parents. The sample consisted of 57 children with Asperger syndrome and 55 children with high-functioning autism. The mean age of the children was 10 years. All subjects were examined with a standardised test battery. Children with AS had a higher full-scale-IQ than children with HFA. This was due to a higher verbal-IQ. There were no significant differences in the performance-IQ. At a mean age of 10 years, subjects with AS had better language skills than subjects with HFA, but at least 30% showed clear receptive language problems. Motor problems were present in about 50% of the children with AS and HFA. The level of psychosocial adaptation was clearly reduced, but was comparable for the two groups. The differences in verbal-IQ and language skills between the two groups could be explained through the definition of the syndromes. The presence of language problems in the subjects with AS at age 10, the comparable degree of motor impairment and level of psychosocial adaptation question the validity of the distinction between AS and HFA within the category of pervasive developmental disorders.     

Response Times of Children and Adolescents with Asperger Syndrome on an ‘Advanced’ Test of Theory of Mind

In the present study the response times of 10- to 20-year-old participants with Asperger syndrome (AS) (N = 21) of normal intelligence and a control group of typically developing individuals (N = 20) were recorded on a new ‘advanced’ test of theory of mind. This test taps the ability to make mental-state inferences versus physical-state inferences in a story context. The participants with AS were significantly slower than the controls on both tasks. In addition, the differences in response times between mental- and physical-state inference were significantly larger in the AS group than in the control group, suggesting that the clinical group experienced more problems than the controls in making inferences about mental states than about physical states.     

Use of Context in Pragmatic Language Comprehension by Children with Asperger Syndrome or High-Functioning Autism

Utilizing relevance theory, this study investigated the ability of children with Asperger syndrome (AS) and high-functioning autism (HFA) to use context when answering questions and when giving explanations for their correct answers. Three groups participated in this study: younger AS/HFA group (age 7–9, n = 16), older AS/HFA group (age 10–12, n = 23) and a normally functioning control group (age 7–9, n = 23). The results indicated that the younger AS/HFA group did less well when answering contextually demanding questions compared to the control group, and the performance of the older AS/HFA group fell in between the younger AS/HFA group and the control group. Both AS/HFA groups had difficulties explaining their correct answers, suggesting that they are not always aware of how they have derived answers from the context.     

Facial emotion recognition and visual search strategies of children with high functioning autism and Asperger syndrome

Adults with high functioning autism (HFA) and Asperger syndrome (AS) are often less able to identify facially expressed emotions than their matched controls. However, results regarding emotion recognition abilities in children with HFA/AS remain equivocal. Emotion recognition ability and visual search strategies of 26 children with HFA/AS and matched controls were compared. An eye tracker measured the number of fixations and fixation durations as participants were shown 12 pairs of slides, displaying photos of faces expressing anger, happiness or surprise. The first slide of each pair showed a face broken up into puzzle pieces. The eyes in half of the puzzle piece slides were bisected, while those in the remaining half were whole. Participants then identified which of three alternative faces was expressing the same emotion shown in the preceding puzzle piece slide. No differences between the participant groups were found for either emotion recognition ability or number of fixations. Both groups fixated more often on the eyes and performed better when the eyes were whole, suggesting that both children with HFA/AS and controls consider the eyes to be the most important source of information during emotion recognition. Fixation durations were longer in the group with HFA/AS, which indicates that while children with HFA/AS may be able to accurately recognise emotions, they find the task more demanding.