Reading decoding and comprehension in children with autism spectrum disorders: Evidence from a language with regular orthography

Decoding and comprehension skills in children with autism spectrum disorders (ASD) were analysed in children native speakers of a language (Italian) with a highly regular orthography. Children with ASD were compared to children with matched intellectual functioning: a subgroup of children with ASD and borderline intellectual functioning (BIF) was compared to a subgroup of children with BIF but no signs of ASD; a subgroup of children with ASD and cognitive functioning within normal limits was compared to a group of typically developing children. Children with ASD (whether with or without BIF) showed essentially spared decoding skills in text as well as word and pseudo-word reading; this was at variance with children with BIF who, as a group, showed overall deficient decoding skills, despite considerable individual differences. By contrast, children with ASD (once again, irrespective of the presence of BIF) showed a selective impairment in reading comprehension, just like children with BIF but unlike the typically developing ones. Therefore, results are generally consistent with a profile of hyperlexia for children with ASD learning a regular orthography, as previously reported for other languages. Notably, this pattern was present irrespective of the degree of cognitive impairment, and clearly distinguished these children from those with borderline intellectual functioning but not signs of autism.     

Transcranial direct current stimulation in psychiatric disorders

The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation (tDCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally, we provide an overview of tDCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding tDCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding tDCS efficacy in psychiatry.     

Stress Changes the Spatial Arrangement of Neurons and Glial Cells of Medial Prefrontal Cortex and Sertraline and Curcumin Prevent It

Objective

The present study explored the three-dimensional spatial arrangements of the neurons and glial cells within the medial prefrontal cortex (mPFC) of rats.

Methods

It evaluated the arrangement for differences after stress with or without treatment with curcumin and sertraline using second-order stereology. Orientator method was applied to obtain isotropic uniform random sections of mPFC. The pair correlation g(r) and cross-correlation functions were estimated by counting dipole probes superimposed on histological sections of mPFC.

Results

The mean total volume of neurons and glial cells was 0.80 (0.05) and 0.40 (0.07), respectively in the control group. The corresponding values decreased by 50% in the stressed group. The curve of g(r) for the neurons and glial cells showed a wider gap between the stressed rats'' mPFC. Theses indicate a negative correlation (repulsion) between the neurons and glial cells in the stressed rats. Evaluation of the cross-correlation function of the neurons and glial cells also showed a negative correlation in the stressed group. The estimated values of the global degree of order in the spatial point pattern for neurons and glial cells were 0.62 and 0.20 in control and stressed animals, respectively. Curcumin and sertraline protected the spatial arrangements of the cells after stress induction in rats. In addition, the volume of the neurons and glial cells remained unchanged after stress.

Conclusion

Dissociation of the neurons and glial cells can is seen at some places in the stressed rats'' cortex. However, the spatial arrangement of the cells was remained unchanged in curcumin+stress and sertraline+stress rats.     

High rates of parkinsonism in adults with autism

Background

While it is now recognized that autism spectrum disorder (ASD) is typically a life-long condition, there exist only a handful of systematic studies on middle-aged and older adults with this condition.

Methods

We first performed a structured examination of parkinsonian motor signs in a hypothesis-generating, pilot study (study I) of 19 adults with ASD over 49 years of age. Observing high rates of parkinsonism in those off atypical neuroleptics (2/12, 17 %) in comparison to published population rates for Parkinson’s disease and parkinsonism, we examined a second sample of 37 adults with ASD, over 39 years of age, using a structured neurological assessment for parkinsonism.

Results

Twelve of the 37 subjects (32 %) met the diagnostic criteria for parkinsonism; however, of these, 29 subjects were on atypical neuroleptics, complicating interpretation of the findings. Two of eight (25 %) subjects not taking atypical neuroleptic medications met the criteria for parkinsonism. Combining subjects who were not currently taking atypical neuroleptic medications, across both studies, we conservatively classified 4/20 (20 %) with parkinsonism.

Conclusions

We find a high frequency of parkinsonism among ASD individuals older than 39 years. If high rates of parkinsonism and potentially Parkinson’s disease are confirmed in subsequent studies of ASD, this observation has important implications for understanding the neurobiology of autism and treatment of manifestations in older adults. Given the prevalence of autism in school-age children, the recognition of its life-long natural history, and the recognition of the aging of western societies, these findings also support the importance of further systematic study of other aspects of older adults with autism.     

Brain magnetic resonance and cognitive function changes in maintenance hemodialysis patients

Objective To investigate cerebrovascular lesions on maintenance hemodialysis (MHD) patients, including types of cerebrovascular disease, and cognitive function changes. Methods A cross-sectional study was applied. A total of 270 MHD patients at hemodialysis center of Peking Union Medical College Hospital were screened, and finally 117 cases were enrolled. Demographic information, aboratory data, MRI and MRA data were collected and assessed. Cognitive function was evaluated with C - MMSE (Chinese mini mental test examination) and C - MoCA (Chinese montreal cognitive assessment). The related factors were selected by Spearman correlation analysis, multiple linear regression and logistic regression analysis. Results The patients’average age was (56.0± 12.5) years, average hemodialysis age was (73.5±60.8) months. Only 5.1% patients had clinical history of cerebral infarction or hemorrhage. Pre - hemodialysis blood pressure was (142.7/80.3±18.2/12.9) mmHg, Post-hemodialysis blood pressure was (130.2/79.1±23.4/14.9) mmHg. A total of 18.8% patients had intra-hemodialysis hypotension, spKt/V was (1.45±0.25). MR results showed that 12.0% patients had cerebral artery stenosis, 5.1% patients had cortical infarcts, 39.3% patients had lacunar infarcts, 47.0% patients had microbleeds, 7.7% patients had chronic hematoma, 52.1% patients had abnormal brain whiter matter lesions (WMLs). In cognitive function evaluation, 20.9% patients had abnormal C-MMSE scores, but 65.2% patients had abnormal C-MoCA results. Multiple linear regression showed age (b=0.059, P＜0.01), dialysis age (b=0.005, P＜0.05) were associated with WMLs in MHD patients. Intra-hemodialysis hypotension was an independent risk factor of lacunar infarcts (b=2.123, P＜0.01) and microbleeds (b=3.531, P＜0.01). Low serum albumin level was an independent risk factor of cognitive decline (b=0.314, P＜0.05). Logistic regression analysis showed pre - hemodialysis systolic blood pressure was an independent risk factor of cortical infarcts [OR=1.088, 95%CI (1.018-1.152), P＜ 0.05]. Gender, dialysis age and pre - dialysis serum TCO2 level were related with chronic hematoma. Conclusions WMLs is related with dialysis voltage. Lacunar infarcts and mirobleeds are related with intra - hemodialysis hypotension. Lacunar infarcts, WMLs and nutritional status are contributed to decline of cognition in MHD patients.     

地氟醚和七氟醚对术中运动诱发电位监测的影响

目的比较地氟醚和七氟醚对术中运动诱发电位(motor evoked potentials,MEPs)监测的影响。方法选择ASAⅠ或Ⅱ级,择期神经外科手术术中行MEPs监测的患者36例,随机均分为两组:地氟醚组(F组)和七氟醚组(S组)。术中监测血流动力学、BIS、MEPs的波幅和潜伏期、肌松(TOF值)、体温。术中保证肌松药作用消失,维持血流动力学平稳,BIS 40~60,体温36~37℃,调节吸入麻醉药浓度,使其呼气末浓度达到0.7、0.8、0.9和1.0 MAC,每一浓度维持10min,测每一浓度下四肢的运动诱发电位,记录其潜伏期和波幅,比较两组各肢体在不同浓度下MEPs的潜伏期和波幅的变化。结果与前一MAC比较,随MAC值增加,左上、下肢体和右上、下肢体的两组MEPs潜伏期明显延长,MEPs波幅明显降低(P0.05)。在0.7、0.8 MAC时,左下肢和右下肢F组的MEPs潜伏期明显长于,MEPs波幅明显低于S组(P0.05);在0.9、1.0 MAC时,左上、下肢体和右上、下肢体的F组的MEPs潜伏期明显长于,MEPs波幅明显低于S组(P0.05)。与前一MAC比较,随MAC值增加,左上、下肢体和右上、下肢体的两组MEPs潜伏期与0.7 MAC时MEPs潜伏期的百分率明显升高,MEPs波幅与0.7 MAC时MEPs波幅的百分率明显减低(P0.05)。结论地氟醚和七氟醚对MEPs均有抑制作用,随着药物浓度的增加,抑制作用逐渐增强,且在同一MAC条件下,似乎地氟醚的抑制作用强于七氟醚。     

Lymphoproliferative disorders in chronic hepatitis C

Chronic hepatitis C virus (HCV) infection is associated with the development of lymphoproliferative disorders (LPDs). The aim of this investigation was to determine the prevalence and characterization of monoclonal gammopathy and benign and malignant LPDs in individuals with chronic hepatitis C. A total of 233 subjects diagnosed with chronic hepatitis C (male/female ratio: 131/102, median age; 49 years) were studied. Serum and urine were examined for the presence of a monoclonal gammopathy. A bone marrow aspirate and biopsy was obtained in individuals with a monoclonal gammopathy. Thirty-two patients (13.7%, 32 of 233) had a monoclonal gammopathy; 75% of them were benign and were not associated with malignant disorders (24 of 32) while 25% were associated with malignant LPDs or a plasma cell disorder (eight of 32). Two additional subjects without monoclonal gammopathy were diagnosed as having a malignant LPDs. The prevalence of malignant LPDs/plasma cell disorder in individuals with HCV-induced chronic liver disease was 4.3%. No difference was found in terms of disease duration, HCV genotype, viral load, alanine aminotransferase level or histopathologic score between the subjects with or without a monoclonal gammopathy. The presence of mixed cryoglobulinaemia was strongly associated with the presence of an underlying malignant disorder. Hence a monoclonal gammopathy is found in 14% of patients with chronic hepatitis C and is associated with malignant B-cell LPD in more than a quarter of such patients. The prevalence of LPDs in individuals with HCV-induced chronic liver disease is greater than that of the normal healthy population.