Some comments on the significance and development of midline behavior during infancy

With the waning of the tonic neck reflex beginning with the 8th to 12th week, and disappearing, in most instances, by the 16th week, the infant begins to become bilateral and makes symmetrical movements and engages his hands in the midline usually over the chest while in a supine position. The developmental significance of such behavior is considered—for example, its participation in the emerging sense of self and its role in the consolidation of emerging ego skills. Consideration is given to the possible implications of faulty midline behavior for development, and to whether failure to engage in an optimal amount of midline behavior, in interaction with other factors, can be used to alert observers to possible future developmental disturbances.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43965/1/10578_2005_Article_BF01435498.pd

Autism and tuberous sclerosis.

Autism is a behavior disorder with genetic influences indicated from twin and family studies and from the co-occurrence of autism with known genetic disorders. Tuberous sclerosis complex (TSC) is a known genetic disorder with behavioral manifestations including autism. A literature review of these two disorders substantiates a significant association of autism and TSC with 17-58% of TSC subjects manifesting autism and 0.4-3% of autistic subjects having TSC. In initial data collected on 13 TSC probands and 14 autistic probands in our family study of autism and TSC, we identified 7 TSC subjects with autism. The seven TSC autistic probands are similar to non-TSC autistic probands on the Social and Communication domains of the Autism Diagnostic Inventory (ADI) (Le Couteur et al., 1989), but show fewer Repetitive Rituals. There are more male TSC probands with autism than female, despite an equal sex ratio among TSC probands. The TSC probands with autism have significantly more seizures and mental retardation than those without autism; however, the extent and etiology of associations require further study. Our preliminary findings suggest that a fruitful approach for delineating genetic influences in autism may come from further investigation of possible mechanisms underlying the association of autism and TSC

The naturalistic follow-up of pervasive developmental disorders–not otherwise specified cases

OBJECTIVES: Pervasive developmental disorders (PDDs) are neurodevelopmental disorders characterized by deficits in social interactions, communication impairments, and the presence of restricted interests and stereotyped behaviours. The issue of diagnostic stability, course, and prognosis of PDDs is an increasing focus of research studies. The aim of this study is to evaluate the individuals who were previously diagnosed with pervasive developmental disorders–not otherwise specified (PDD–NOS) (one of the sub-diagnoses of PDDs) under age six years with respect to their current diagnoses. METHODS: The participants were selected among the patients who were diagnosed with PDD–NOS under six years of age in our outpatient clinic. We obtained 208 patients’ file records. We were able to reach 92 patients’ parent by telephone and 58 parents accepted to voluntarily participate. After the excluded cases, finally 51 patients were evaluated in this cross-sectional naturalistic follow-up study. Children Autism Rating Scale (CARS) and Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) were administered to participants; Autism Behavior Checklist (ABC) was completed by their parents. RESULTS: There were 44 (86.3%) male and 7 (13.7%) female participants in the study. The current mean age was 8.62 years (SD = 2.25). The mean age at the time of first diagnosis was 3.56 years (SD = 1.22). The mean duration of the follow-up period was 5.05 years (SD = 2.27). Forty-five (88.2%) of 51 patients remained to have one of the PDDs (23 autistic disorder, 22 PDD–NOS) according to DSM-IV-TR. Six patients (11.8%) did not meet the diagnostic criteria of any PDDs. Two of these six patients diagnosed with attention-deficit/hyperactivity disorder and one with mild-level intellectual disability. CONCLUSIONS: It was observed that 11.8% patients who diagnosed as PDD–NOS less than six years old were found to be off the PDD spectrum. PDD–NOS diagnosis stability was found 43.1% and 45.1% of the patients moved to another PDD diagnosis. These findings should be supported with further studies in Turkey, by increasing sample size, and follow-up duration for understanding the course

Night sleep electroencephalogram power spectral analysis in excessive daytime sleepiness disorders

A group of 53 patients (40 míales, 13 females) with mean age of 49 years, ranging from 30 to 70 years, was evaluated in the. following excessive daytime sleepiness (EDS) disorders : obstructive sleep apnea syndrome (B4a), periodic movements in sleep (B5a), affective disorder (B2a), functional psychiatric non affective disorder (B2b). We considered all adult patients referred to the Center sequentially with no other distinctions but these three criteria: (a) EDS was the main complaint; (b) right handed ; (c) not using psychotropic drugs for two weeks prior to the all-night polysomnography. EEG (C3/A1, C4/A2) samples from 2 to 10 minutes of each stage of the first REM cycle were chosen. The data was recorded simultaneously in magnetic tape and then fed into a computer for power spectral analysis. The percentage of power (PP) in each band calculated in relation to the total EEG power was determined of subsequent sections of 20.4 s for the following frequency bands: delta, theta, alpha and beta. The PP in all EOS patients sample had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage. PP distribution in the delta range increased progressively from stage 1 to stage 4; stage REM levels were close to stage 2 levels. In an EDS patients interhemispheric coherence was high in every band and sleep stage. B4a patients sample PP had a tendency to decrease progressively from the slowest to the fastest frequency bands, in¡ every sleep stage; PP distribution in the delta range increased progressively from stage 1 to stage 4; stage REM levels were between stage 1 and stage 2 levels. B2a patients sample PP had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage; PP distribution in the delta range increased progressively from stage 1 to stage 4; stage REM levels were close to stage 2 levels. B2b patients sample PP had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage; PP distribution in the delta range increased progressively from stage 1 to stage 3; stage 4 levels were close to stage 3 levels; stage REM levels were close to stage 2. B5a patients sample PP had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage; PP distribution in the delta range increased progressively from stage 1 to stage 3; stage REM levels were close to stage 2 levels, Interhemispheric coherences of B4a, B2b, and B5a groups were high in, every band and sleep stage. B4a, B2a, B2b, and B5a power spectral analysis comparison showed higher PP in B2b stage 1 alpha band, as well as, higher PP in B5a stage 2 theta band. The B4a versus. B2a power spectral analysis comparison showed higher PP in B4a stages 1 and REM alpha bands, as well as higher PP in B2a stage REM delta band