The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children – What Do We Know?

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorder (ASD) often co-occur. The DSM IV had specified that an ASD diagnosis is an exclusion criterion for ADHD, thereby limiting research of this common clinical co-occurrence. As neurodevelopmental disorders, both ASD and ADHD share some phenotypic similarities, but are characterized by distinct diagnostic criteria. The present review will examine the frequency and implications of this clinical co-occurrence in children, with an emphasis on the available data regarding preschool age. The review will highlight possible etiologies explaining it, and suggest future research directions necessary to enhance our understanding of both etiology and therapeutic interventions, in light of the new DSM V criteria , allowing for a dual diagnosis

Lack of Association between Anti-Phospholipid Antibodies (APLA) and Attention Deficit/Hyperactivity Disorder (ADHD) in Children

Numerous studies have shown the pathological influence anti-phospholipid antibodies (APLA) have on the physiology of the single neuron as well as the function of the entire human nervous system. The influence is well demonstrated in the antiphospholipid syndrome (APS). This syndrome is characterized by a triad of arterial or venous thrombotic events, recurrent fetal loss and thrombocytopenic purpura. The syndrome exhibits different neurological pathologies such as: chorea, seizures, transverse myelopathy, migraine, cerebral ataxia, hemiballismus and transient global amnesia, which are not fully explained by the procoagulopathic trait of APLA. A study on mice induced with APS demonstrated hyperactive behavior when compared to the control group. The information gathered from these different studies raised the question whether APLA has any part in the etiology of Attention Deficit/Hyperactive Disorder (ADHD) in children

DNA Repair Biomarker for Lung Cancer Risk and its Correlation With Airway Cells Gene Expression.

Background: Improving lung cancer risk assessment is required because current early-detection screening criteria miss most cases. We therefore examined the utility for lung cancer risk assessment of a DNA Repair score obtained from OGG1, MPG, and APE1 blood tests. In addition, we examined the relationship between the level of DNA repair and global gene expression. Methods: We conducted a blinded case-control study with 150 non-small cell lung cancer case patients and 143 control individuals. DNA Repair activity was measured in peripheral blood mononuclear cells, and the transcriptome of nasal and bronchial cells was determined by RNA sequencing. A combined DNA Repair score was formed using logistic regression, and its correlation with disease was assessed using cross-validation; correlation of expression to DNA Repair was analyzed using Gene Ontology enrichment. Results: DNA Repair score was lower in case patients than in control individuals, regardless of the case's disease stage. Individuals at the lowest tertile of DNA Repair score had an increased risk of lung cancer compared to individuals at the highest tertile, with an odds ratio (OR) of 7.2 (95% confidence interval [CI] = 3.0 to 17.5; P < .001), and independent of smoking. Receiver operating characteristic analysis yielded an area under the curve  of 0.89 (95% CI = 0.82 to 0.93). Remarkably, low DNA Repair score correlated with a broad upregulation of gene expression of immune pathways in patients but not in control individuals. Conclusions: The DNA Repair score, previously shown to be a lung cancer risk factor in the Israeli population, was validated in this independent study as a mechanism-based cancer risk biomarker and can substantially improve current lung cancer risk prediction, assisting prevention and early detection by computed tomography scanning.This work was funded by grants from NIH/NCI/EDRN (#1 U01 CA111219), the Flight Attendant Medical Research Institute, Florida, the Mike Rosenbloom Foundation and Weizmann Institute of Science to ZL and TPE; and by grants from Cancer Research UK to BP and to the Cancer Research UK Cambridge Centre; and by a UK National Institute for Health Research Senior Fellowship to BP; and by the Cambridge Biomedical Research Centre and the Cancer Research UK Cambridge Centre to RCR. Volunteer participant recruitment through the Cambridge Bioresource was funded by the Cambridge Biomedical Research Centre

Brain Diffusivity in Infants With Hypoxic-Ischemic Encephalopathy Following Whole Body Hypothermia: Preliminary Results

Abstract Hypoxic-ischemic encephalopathy is an important cause of neuropsychological deficits. Little is known about brain diffusivity in these infants following cooling and its potential in predicting outcome. Diffusion tensor imaging was applied to 3 groups: (1) three infants with hypoxic-ischemic encephalopathy: cooled; (2) three infants with hypoxic-ischemic encephalopathy: noncooled; and (3) four controls. Diffusivity values at the corticospinal tract, thalamus, and putamen were correlated with Apgar scores and early neurodevelopmental outcome. While cooled infants exhibited lower Apgar scores than noncooled infants, their developmental scores at a mean age of 8 months were higher. All groups differed in their diffusivity values with the cooled infants showing better values compared with the noncooled, correlating with early neurodevelopmental outcome. These preliminary results indicate that diffusion tensor imaging performed at an early age in infants with hypoxic-ischemic encephalopathy may forecast clinical outcome and support the neuroprotective effect of hypothermia treatment

A comparison of attention-deficit/hyperactivity disorder with autism spectrum disorder on cognitive, neural, and emotional estimates: a systematic review

Background: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are two neurodevelopmental disorders that share common symptoms and frequently co-occur. We performed a systematic review of studies examining three main domains in ADHD vs ASD; executive functions, brain structures and functions, and emotional skills, in an effort to better understand their co-occurrence. Methods: As ADHD and ASD frequently co-occur, we chose to focus on the relevant articles comparing ADHD (with no ASD) and ASD (with no ADHD) populations using appropriate measures. A systematic literature search was conducted using six electronic databases, up to May 18, 2022. Results: A total of 19 articles were included. No significant differences were found in executive functioning between ADHD and ASD. For emotional skills, results were inconclusive, with greater theory of mind (ToM) and empathy skills in ADHD relative to ASD, but no significant differences in emotion recognition. Regarding brain structure and functions, there were inconsistent findings, with some studies reporting weaker brain connectivity in ASD, and reduced gray and white matter volumes in ADHD, while others reported no significant differences. Conclusions: Our review suggests a lack of studies directly examining ASD compared with ADHD. The existing literature does not suggest a unique association of either ASD/ADHD with executive dysfunction, emotional skills deficits, or brain structure/function abnormalities. Consequently, further research is necessary to develop a more comprehensive understanding of the overlaps and differences between these disorders and to address the existing gaps in knowledge

Brain Development and the Attention Spectrum

Early-onset and enduring developmental deficits in attention, especially if combined with increased hyperactivity, and impulsivity, may result in constant impairments in multiple domains of personal life. The full spectrum of symptoms is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity, which is maladaptive and inconsistent with a comparable level of developmental age known as Attention Deficit Hyperactivity Disorder (ADHD). ADHD is considered one of the most common neurobehavioral disorders and of childhood, and among the most prevalent chronic health conditions.Given the wide heterogeneity and complex manifestations of the disorder, there is an importance in a developmental perspective that views ADHD as a multi-factorial disorder with multiple, causal processes, and pathways. The symptoms of ADHD should be cast, not as static or fixed neurobehavioral deficits, but rather in terms of underlying developmental processes.Even experienced professional might minimize the prevalence of a disorder among certain groups of patients. Therefore, the existence of attention disorders might become ""transparent"" for both the patient and the professional. This might lead to a non-accurate diagnosis, harm the treatment aspects and has potential non beneficial prognostic aspects.The developmental approach can provide predictions as to how characteristics associated with attention develop over time and how multiple risk and protective factors transact to impact it's development, as well as the development of a broad range of associated co-morbid features.Among children with mental retardation, autistic spectrum disorders, children who were born premature, born with low birth weight, as well as among those who suffer from chronic disorders (such as epilepsy, diabetes, chronic kidney disease or asthma), as well as among otherwise healthy preschoolers - the assessment of attention performance might be very challenging. In this research topic, we explore the latest cutting edge research on the biological and neural pathways as well as on psychosocial and behavioral correlates of brain development and attention spectrum. In doing so we aim to highlight: what is currently known regarding this new conceptualization of attention as a spectrum; the mechanisms underlying this spectrum; and where this field is headed in terms of developing our understanding of the link between brain development and attention performance

Zróżnicowanie diagnozy ASD ze względu na wykorzystanie ADOS-2 i DSM-5 – badania wstępne

This study compares the classification of ASD using ADOS-2 with diagnoses using DSM-5 among children between 8 and 10 years old. Case series data were used on four children who were referred with suspected autism, and as a result a discrepancy was found between the ADOS-2 assessment and the overall diagnosis. Initial findings indicated that age, additional diagnoses, and over-reliance on observa- tion may bias the ADOS-2 classification. In particular, children who were diagnosed with other disorders that share symptoms with ASD exhibit behaviors that may bias the ADOS-2 classification as it relies on observed behavior without considering the underlying cause. This discrepancy points to the importance of utilizing and integrating multiple sources of information in the process of establishing an ASD diagnosis, and suggests a need for specialized clinical training in diagnosing autism and other related co-morbid conditions in children aged 8–10. This preliminary data calls for further research into the area, especially due to the cur- rent over-reliance on the ADOS-2 in clinical practice and research.Niniejsze badanie dotyczy zróżnicowania diagnozy ASD ze względu na zastosowane narzędzia diagnostyczne. Dane uzyskane przy pomocy dwu narzędzi diagnostycznych – ADOS-2 i DSM-5 od czworga dzieci z podejrzeniem autyzmu w wieku od 8 do 10 lat zostały porównane pod kątem zgodności uzyskanych przy ich pomocy wyników. W wyniku analizy stwierdzono zróżnicowanie wyników ze względu na zastosowane narzędzia. Wstępne ustalenia wskazywały, że wiek oraz dodatkowo zdiagnozowane zaburzenia współwystępujące i nadmierna koncentracja na obserwacji mogą zniekształcić wyniki ADOS -2. W szczególności u dzieci ze zdiagnozowanymi innymi zaburzeniami objawiającymi się poprzez zachowania podobne do autystycznych, diagnoza uzyskana przy pomocy ADOS-2, może być zniekształcona, gdyż nie uwzględnia podstawowej przyczyny zaburzeń. Rozbieżność ta wskazuje na konieczność wykorzystania i połączenia wielu źródeł informacji w procesie diagnozowania ASD, a także sugeruje potrzebę specjalistycznego szkolenia klinicystów w zakresie diagnostyki autyzmu i innych współistniejących schorzeń u dzieci w wieku 8–10 lat. Te wstępne wyniki są obiecujące, lecz wymagają dalszego empirycznego potwierdzenia, szczególnie ze względu na częste obecnie wykorzystywanie ADOS-2 w praktyce klinicznej i badaniach

Expression and Functional Analyses of the Plastid Lipid-Associated Protein CHRC Suggest Its Role in Chromoplastogenesis and Stress

Chromoplastogenesis during flower development and fruit ripening involves the dramatic overaccumulation of carotenoids sequestered into structures containing lipids and proteins called plastid lipid-associated proteins (PAPs). CHRC, a cucumber (Cucumis sativus) PAP, has been suggested to be transcriptionally activated in carotenoid-accumulating flowers by gibberellin (GA). Mybys, a MYB-like trans-activator identified here, may represent a chromoplastogenesis-related factor: Its expression is flower specific and parallels that of ChrC during flower development; moreover, as revealed by stable ectopic and transient-expression assays, it specifically trans-activates ChrC promoter in flowers accumulating carotenoids and flavonoids. A detailed dissection of ChrC promoter revealed a GA-responsive element, gacCTCcaa, the mutation of which abolished ChrC activation by GA. This cis-element is different from the GARE motif and is involved in ChrC activation probably via negative regulation, similar to other GA-responsive systems. The GA responsiveness and MYBYS floral activation of the ChrC promoter do not overlap with respect to cis-elements. To study the functionality of CHRC, which is activated in vegetative tissues similar to other PAPs by various biotic and abiotic stresses, we employed a tomato (Lycopersicon esculentum) plant system and generated RNAi-transgenic lines with suppressed LeCHRC. Transgenic flowers accumulated approximately 30% less carotenoids per unit protein than controls, indicating an interrelationship between PAPs and flower-specific carotenoid accumulation in chromoplasts. Moreover, the transgenic LeCHRC-suppressed plants were significantly more susceptible to Botrytis cinerea infection, suggesting CHRC's involvement in plant protection under stress conditions and supporting the general, evolutionarily preserved role of PAPs