Small fiber pathology in autism and clinical implications

Chien, Yi‐Ling; Chao, Chi‐Chao; Wu, Sheng; Hsueh, Hsueh‐Wen; Chiu, Yen-Nan; Tsai, Wei Chuan; Gau, Susan Shur‐Fen; Hsieh, Sung‐Tsang

doi:10.1212/wnl.0000000000010932

Cited by 23 publications

(23 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of intellectually-abled (IQ > 70) autistic individuals tend to experience increased pain and touch sensitivity, particularly in areas innervated by small unmyelinated C-fibers [ 88 ]. Chien et al [ 91 ] reported the presence of small C-fiber pathology (denervation) in more than half of their adult male cases, a finding that shared a U-shaped relationship with autism severity. Another small study by Silva and Schalock [ 92 ] investigated C-fiber innervation in the skin of four autistic children with hypoesthesia and allodynia, again finding reduced density of nerve fibers within the regions studied.…”

Section: Symptom Overlap Between Autism and Ehlers-danlos Syndromementioning

confidence: 99%

“…As discussed in the previous section, many autistic people display signs of small fiber neuropathy within the skin [ 91 , 92 ]. These same types of small unmyelinated C-fibers are intimately involved in the autonomic nervous system, suggesting that structural and functional damage may also be present within this system as well.…”

Section: Symptom Overlap Between Autism and Ehlers-danlos Syndromementioning

confidence: 99%

See 1 more Smart Citation

The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders

Casanova

Baeza-Velasco

Buchanan

et al. 2020

JPM

View full text Add to dashboard Cite

Considerable interest has arisen concerning the relationship between hereditary connective tissue disorders such as the Ehlers-Danlos syndromes (EDS)/hypermobility spectrum disorders (HSD) and autism, both in terms of their comorbidity as well as co-occurrence within the same families. This paper reviews our current state of knowledge, as well as highlighting unanswered questions concerning this remarkable patient group, which we hope will attract further scientific interest in coming years. In particular, patients themselves are demanding more research into this growing area of interest, although science has been slow to answer that call. Here, we address the overlap between these two spectrum conditions, including neurobehavioral, psychiatric, and neurological commonalities, shared peripheral neuropathies and neuropathologies, and similar autonomic and immune dysregulation. Together, these data highlight the potential relatedness of these two conditions and suggest that EDS/HSD may represent a subtype of autism.

show abstract

Section: Symptom Overlap Between Autism and Ehlers-danlos Syndromementioning

confidence: 99%

Section: Symptom Overlap Between Autism and Ehlers-danlos Syndromementioning

confidence: 99%

The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders

Casanova

Baeza-Velasco

Buchanan

et al. 2020

JPM

View full text Add to dashboard Cite

show abstract

“…This effect may, however, depend on frequency and body site (26,30) and is not universally reported (28,32). Interestingly, some autistic adults may have diminished density of small intraepidermal nerve fibers, which was related to elevated sensory thresholds to thermal stimuli (33).…”

Section: Behavioural Thresholdsmentioning

confidence: 99%

“…After correcting for multiple comparisons, we found no significant correlations between hearing thresholds and AASP/SP auditory low threshold scores or SEQ auditory EP scores; between Von Frey thresholds and AASP/SP Tactile Low Threshold or SEQ overall EP scores; or between JVP dome thresholds and AASP/SP Tactile Low Threshold or SEQ overall EP scores, all Holm-Bonferroni corrected p's ≥ . 33.…”

Section: Psychophysical -Questionnaire Associationsmentioning

confidence: 99%

A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities

Dwyer¹,

Takarae²,

Zadeh³

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundReconciling results obtained using different types of sensory measures is a challenge for autism sensory research. The present study used questionnaire, psychophysical, and neurophysiological measures to characterize autistic sensory processing in different measurement modalities.MethodsParticipants were 46 autistic and 21 typically-developing adolescents. Participants and their caregivers completed questionnaires regarding sensory experiences and behaviours. Auditory and somatosensory ERPs were recorded as part of a multisensory ERP task. Auditory, tactile static detection, and tactile spatial resolution psychophysical thresholds were measured.ResultsSensory questionnaires strongly differentiated between autistic and typically-developing individuals, while little evidence of group differences was observed in psychophysical thresholds. Crucially, the different types of measures (neurophysiological, psychophysical, questionnaire) appeared to be largely independent of one another. However, we unexpectedly found autistic participants with larger auditory Tb ERP amplitudes had reduced hearing acuity, even though all participants had hearing acuity in the non-clinical range.LimitationsThe autistic and typically-developing groups were not well-matched, although this limitation does not affect our main analyses regarding convergence of measures within ASD. The autistic sample in the present study is not representative of the whole autistic constellation, limiting generalizability. Auditory ERPs and auditory thresholds were measured with non-equivalent stimuli.ConclusionsOverall, based on these results, measures in different sensory modalities appear to capture distinct aspects of sensory processing in autism, with relatively limited convergence between questionnaires and laboratory-based tasks. Generally, this might reflect the reality that laboratory tasks are often carried out in controlled environments without background stimuli to compete for attention, a context which may not closely resemble the busier and more complex environments in which autistic people’s atypical sensory experiences commonly occur. For this reason, sensory questionnaires may be more practically useful assessments of autistic people’s real-world sensory challenges. Further research is needed to replicate and investigate the drivers of the unexpected association we observed between auditory Tb ERP amplitudes and hearing acuity, which could represent an important confound for ERP researchers to consider in their studies.

show abstract

“…Researchers have realized that ASD is not only a disorder of brain, with the peripheral nervous, immune and metabolic systems playing a role in its pathogenesis, i.e. a disorder with systematic issues [13][14][15]. For example, one study with 32 autistic men indicated the participation of peripheral sensory nerves in etiology, possibly abnormal tactile sensation [13].…”

Section: Introductionmentioning

confidence: 99%

Saliva nitrite is higher in male children with autism spectrum disorder and positively correlated with serum nitrate

Yao

Bai

et al. 2021

Redox Report

View full text Add to dashboard Cite

Objectives Nitric oxide (NO) plays a vital role in neurological development. As an easily accessible and non-invasive fluid, saliva hasn't been evaluated for nitrite among children with autism spectrum disorder (ASD). This study aims to quantify saliva nitrite and explore its relation with serum NO. Methods Saliva sampling and pretreatment methods were optimized, followed by NO measurement via chemiluminescence for 126 ASD children and 129 normally developing children (ND). Results In the ASD group, saliva nitrite was significantly higher than that in the ND, with concentrations of 4.97 ± 3.77 μM and 2.66 ± 2.07 μM ( p < 0.0001), respectively. Positive correlation was observed between saliva NO 2 − and serum NO 3 − in ASD children, which didn't exist in the ND group. Male children in the ASD group had significantly higher NO than that in boys of the ND group, without significant difference between girls in both groups. Correlation was not found between saliva or serum NO and severity of these ASD children. Discussion It is reported for the first time that saliva nitrite was positively correlated with serum nitrate in ASD children, with significantly higher NO only in autistic boys. Non-invasive saliva might serve as a predictor of health status of ASD children.

show abstract

Small fiber pathology in autism and clinical implications

Cited by 23 publications

References 35 publications

The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders

The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders

A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities

Saliva nitrite is higher in male children with autism spectrum disorder and positively correlated with serum nitrate

Contact Info

Product

Resources

About