McCue Lena M, Flick Louise H, Twyman Kimberly A, Xian Hong, Conturo Thomas E
Division of Biostatistics, Washington University in St. Louis, School of Medicine, 660 Euclid Ave., St. Louis, MO, 63110, USA.
Epidemiology Department, Saint Louis University, College for Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO, 63104, USA.
BMC Neurol. 2016 Nov 28;16(1):245. doi: 10.1186/s12883-016-0764-3.
Autism spectrum disorder (ASD) is a heterogeneous disorder characterized not only by deficits in communication and social interactions but also a high rate of co-occurring disorders, including metabolic abnormalities, gastrointestinal and sleep disorders, and seizures. Seizures, when present, interfere with cognitive development and are associated with a higher mortality rate in the ASD population.
To determine the relative prevalence of non-febrile seizures in children with idiopathic ASD from multiplex and simplex families compared with the unaffected siblings in a cohort of 610 children with idiopathic ASD and their 160 unaffected siblings, participating in the Autism Genetic Resource Exchange project, the secondary analysis was performed comparing the life-time prevalence of non-febrile seizures. Statistical models to account for non-independence of observations, inherent with the data from multiplex families, were used in assessing potential confounding effects of age, gender, and history of febrile seizures on odds of having non-febrile seizures.
The life-time prevalence of non-febrile seizures was 8.2% among children with ASD and 2.5% among their unaffected siblings. In a logistic regression analysis that adjusted for familial clustering, children with ASD had 5.27 (95%CI: 1.51-18.35) times higher odds of having non-febrile seizures compared to their unaffected siblings. In this comparison, age, presence of gastrointestinal dysfunction, and history of febrile seizures were significantly associated with the prevalence of non-febrile seizures.
Children with idiopathic ASD are significantly more likely to have non-febrile seizures than their unaffected siblings, suggesting that non-febrile seizures may be ASD-specific. Further studies are needed to determine modifiable risk factors for non-febrile seizures in ASD.
自闭症谱系障碍（ASD）是一种异质性疾病，其特征不仅在于沟通和社交互动方面的缺陷，还在于共病率高，包括代谢异常、胃肠道和睡眠障碍以及癫痫发作。癫痫发作一旦出现，就会干扰认知发展，并与ASD人群较高的死亡率相关。
为了确定来自多重和单重家庭的特发性ASD儿童中非热性癫痫发作的相对患病率，并与610名特发性ASD儿童及其160名未受影响的兄弟姐妹组成的队列中的未受影响的兄弟姐妹进行比较，这些儿童参与了自闭症遗传资源交换项目，进行了二次分析，比较了非热性癫痫发作的终生患病率。考虑到多重家庭数据固有的观察值非独立性的统计模型，用于评估年龄、性别和热性惊厥史对非热性癫痫发作几率的潜在混杂影响。
ASD儿童中非热性癫痫发作的终生患病率为8.2%，其未受影响的兄弟姐妹中为2.5%。在一项针对家族聚集进行调整的逻辑回归分析中，与未受影响的兄弟姐妹相比，ASD儿童发生非热性癫痫发作的几率高5.27倍（95%CI：1.51 - 18.35）。在该比较中，年龄、胃肠道功能障碍的存在以及热性惊厥史与非热性癫痫发作的患病率显著相关。
特发性ASD儿童比其未受影响的兄弟姐妹更有可能发生非热性癫痫发作，这表明非热性癫痫发作可能是ASD特有的。需要进一步研究以确定ASD中非热性癫痫发作的可改变风险因素。
