Oerlemans Anoek M, Burmanje Marlot J, Franke Barbara, Buitelaar Jan K, Hartman Catharina A, Rommelse Nanda N J
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud university medical center, Nijmegen, The Netherlands.
Karakter, Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.
J Abnorm Child Psychol. 2016 Jul;44(5):923-35. doi: 10.1007/s10802-015-0081-0.
Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) frequently co-occur. Besides shared genetic factors, pre- and perinatal risk factors (PPFs) may determine if ASD, ADHD, or the combination of both disorders becomes manifest. This study aimed to test shared and unique involvement of PPFs for ASD and ADHD, using an approach that stratifies the sample into affected/unaffected offspring and single-incidence (SPX) versus multi-incidence (MPX) families. Pre- perinatal data based on retrospective parent-report were collected in 288 children (71 % males) from 31 SPX and 59 MPX ASD families, 476 children (65 % males) from 31 SPX and 171 MPX ADHD families, and 408 control children (42 % males). Except for large family size and more firstborns amongst affected offspring, no shared PFFs were identified for ASD and ADHD. PPFs predominantly related to ASD (maternal infections and suboptimal condition at birth) were more often reported in affected than unaffected siblings. PPFs associated with ADHD (low parental age, maternal diseases, smoking and stress) were shared between affected and unaffected siblings. Firstborn-ship was more frequent in SPX than MPX ASD probands. Our results suggest that the co-morbidity of ASD and ADHD is not likely explained by shared PPFs. Instead, PPFs might play a crucial role in the developmental pathways leading up to either disorder. PPFs in ADHD appear to index an increased shared risk, whereas in ASD PPFs possibly have a more determining role in the disorder. SPX-MPX stratification detected possible etiological differences in ASD families, but provided no deeper insight in the role of PPFs in ADHD.
自闭症谱系障碍（ASD）和注意力缺陷多动障碍（ADHD）经常同时出现。除了共同的遗传因素外，产前和围产期风险因素（PPF）可能决定ASD、ADHD或两种疾病的组合是否会显现出来。本研究旨在通过将样本分层为受影响/未受影响的后代以及单发病例（SPX）与多发病例（MPX）家庭的方法，测试PPF对ASD和ADHD的共同和独特影响。基于回顾性家长报告收集了来自31个SPX和59个MPX自闭症家庭的288名儿童（71%为男性）、来自31个SPX和171个MPX多动症家庭的476名儿童（65%为男性）以及408名对照儿童（42%为男性）的产前和围产期数据。除了大家庭规模以及受影响后代中头胎较多外，未发现ASD和ADHD有共同的PPF。与ASD相关的PPF（母亲感染和出生时状况欠佳）在受影响的兄弟姐妹中比未受影响的兄弟姐妹中更常被报告。与ADHD相关的PPF（父母年龄小、母亲疾病、吸烟和压力）在受影响和未受影响的兄弟姐妹中都有。SPX自闭症先证者中头胎的比例比MPX更高。我们的结果表明，ASD和ADHD的共病不太可能由共同的PPF来解释。相反，PPF可能在导致这两种疾病的发育途径中起关键作用。ADHD中的PPF似乎表明共同风险增加，而在ASD中PPF可能在该疾病中起更具决定性的作用。SPX-MPX分层检测到了自闭症家庭中可能的病因差异，但没有更深入地了解PPF在ADHD中的作用。
