Epilepsy and Autism Spectrum Disorder: An Epidemiological Study in Shanghai, China

Zhang, Anyi; Li, Jijun; Zhang, Yiwen; Jin, Xingming; Ma, Jun

doi:10.3389/fpsyt.2019.00658

Cited by 9 publications

(9 citation statements)

References 53 publications

(58 reference statements)

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“…Epilepsy is a neurological disorder that is characterized by spontaneous and reoccurring seizures (Profa & Franceschettia, 2003). The prevalence of epilepsy in the general population was 4.6/1000 in Northern Italy (Giussani et al, 2014) and 2.4/1000 in China (Zhang et al, 2019), and that of epilepsy in individuals with autism ranges from 2.4% to 46% (Amiet et al, 2013;Anukirthiga et al, 2019;Danielsson et al, 2005;Neumeyer et al, 2019), which significantly exceeded that of the general population. Similarly, ASDs are prevalent in children with epilepsy.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence estimates of epilepsy in autistic individuals reported in the literature are varied (Lauritsen et al, 2002; Surén et al, 2012; Viscidi et al, 2014; Vohra et al, 2017; Williams et al, 2008; Zhang et al, 2019). A previous meta-analysis reported that the prevalence of epilepsy was 21.5% in autistic subjects with intellectual disability (ID) versus 8% in autistic subjects without ID based on the studies published from 1963 through 2006 (Amiet et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Liu

Sun

et al. 2021

Autism

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The literature from inception to 2020 on the prevalence of epilepsy in autistic individuals was systematically reviewed and further explored by subgroup analyses and meta-regression models. This systematic review is registered with PROSPERO (CRD42020179725). A total of 66 studies from 53 articles were included. The updated pooled prevalence of epilepsy in autistic individuals was 10% (95% CI: 6–14). The respective prevalence estimate of epilepsy was 19% (95% CI: 6–35) in the clinical sample-based cross-sectional study, 7% (95% CI: 3–11) in the cohort study, and 9% (95% CI: 5–15) in the population-based cross-sectional study. The pooled prevalence of epilepsy was 7% (95% CI: 4–11) in autistic children and 19% (95% CI: 14–24) in autistic adults. Compared to the school-aged group, the adolescence group (OR: 1.15, 95% CI: 1.06–1.25) and the pre-school group (OR: 1.06, 95% CI: 0.94–1.19) were positively associated with the prevalence of epilepsy. The moderators of age, human development index of the country, gender, and intellectual function accounted for most of the heterogeneity. The prevalence estimates were associated with age, female gender, intellectual disability rate, and the human development index of countries. About 1/10 autistic individuals co-occurred with epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability, and less common in the country with high human development index. Lay abstract Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11–17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7–10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Liu

Sun

et al. 2021

Autism

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“…About 25% of children with treatment-resistant epilepsy are comorbid with ASD and often present other severe comorbidities, such as sleep disturbances, intellectual disability, or other psychiatric conditions [ 78 ]. Additionally, as mentioned above, epilepsy is one of the most frequent medical comorbidities in people with ASD [ 12 , 13 , 14 , 15 ], and is also found to be more common in those patients with autism-like behaviors as part of phenotypes of genetic syndromes (i.e., Angelman, Rett syndrome, etc.) [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

“…Medical comorbidities are also highly prevalent among the ASD population [ 9 , 10 , 11 ]. In particular, epilepsy represents the most frequent co-occurring neurological condition, affecting 5 to 30% of individuals with ASD [ 12 , 13 , 14 , 15 ]. Even in absence of frank seizures, people with ASD seem to present subclinical electrical discharges with abnormalities in EEG patterns [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies

et al. 2020

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The etiopathogenesis of autism spectrum disorder (ASD) remains largely unclear. Among other biological hypotheses, researchers have evidenced an imbalance in the endocannabinoid (eCB) system, which regulates some functions typically impaired in ASD, such as emotional responses and social interaction. Additionally, cannabidiol (CBD), the non-intoxicating component of Cannabis sativa, was recently approved for treatment-resistant epilepsy. Epilepsy represents a common medical condition in people with ASD. Additionally, the two conditions share some neuropathological mechanisms, particularly GABAergic dysfunctions. Hence, it was hypothesized that cannabinoids could be useful in improving ASD symptoms. Our systematic review was conducted according to the PRISMA guidelines and aimed to summarize the literature regarding the use of cannabinoids in ASD. After searching in Web of KnowledgeTM, PsycINFO, and Embase, we included ten studies (eight papers and two abstracts). Four ongoing trials were retrieved in ClinicalTrials.gov. The findings were promising, as cannabinoids appeared to improve some ASD-associated symptoms, such as problem behaviors, sleep problems, and hyperactivity, with limited cardiac and metabolic side effects. Conversely, the knowledge of their effects on ASD core symptoms is scarce. Interestingly, cannabinoids generally allowed to reduce the number of prescribed medications and decreased the frequency of seizures in patients with comorbid epilepsy. Mechanisms of action could be linked to the excitatory/inhibitory imbalance found in people with ASD. However, further trials with better characterization and homogenization of samples, and well-defined outcomes should be implemented.

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“…Additionally, as mentioned above, epilepsy is one of the main medical comorbidities in people with ASD [12][13][14][15], and has also been found to be more common in those patients with autism-like behaviors as part of phenotypes of genetic syndromes (i.e. Angelman, Rett syndrome, etc.)…”

Section: Mechanisms Of Action: the Role Of Excitatory/inhibitory Systemmentioning

confidence: 97%

Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies

Fusar-Poli

Cavone

Tinacci

et al. 2020

Preprint

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The etiopathogenesis of autism spectrum disorder (ASD) remains largely unclear. Among other biological hypotheses, researchers have evidenced an imbalance in the endocannabinoid (eCB) system, which regulates some functions typically impaired in ASD, such as emotional responses and social interaction. Also, cannabidiol (CBD), the non-intoxicating component of Cannabis sativa, has been recently approved for treatment-resistant epilepsy. Seizures represent frequent medical comorbidities of ASD and could be responsible for the onset or worsening of behavioral problems. Thus, it has been hypothesized that cannabinoids could be useful in improving some ASD symptoms. Our systematic review was conducted according to the PRISMA guidelines and aimed to summarize the literature regarding the use of cannabinoids in ASD. After searching in Web of KnowledgeTM, PsycINFO, and Embase, we included ten studies (eight papers and two abstracts). Four ongoing trials were retrieved in ClinicalTrials.gov. Findings are promising, as cannabinoids appeared to improve problem behaviors, sleep, hyperactivity, and communication deficits, with limited cardiac and metabolic side effects. Interestingly, they generally allowed to reduce the number of prescribed medications and decreased the frequency of seizures in epileptic patients. Mechanisms of action could be linked to the excitatory/inhibitory imbalance found in people with ASD. However, further trials need to be implemented with better characterization and homogenization of samples, and well-defined outcomes.

show abstract

Epilepsy and Autism Spectrum Disorder: An Epidemiological Study in Shanghai, China

Cited by 9 publications

References 53 publications

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies

Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies

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