患有自闭症谱系障碍的先证者的未患病同胞中与注意力缺陷多动障碍相关的症状及注意力特征：聚焦于自闭症和阿斯伯格障碍的亚型
ADHD-related symptoms and attention profiles in the unaffected siblings of probands with autism spectrum disorder: focus on the subtypes of autism and Asperger's disorder.
作者信息
Chien Yi-Ling, Chou Miao-Chun, Chiu Yen-Nan, Chou Wen-Jiun, Wu Yu-Yu, Tsai Wen-Che, Gau Susan Shur-Fen
机构信息
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, 10002 Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
出版信息
Mol Autism. 2017 Jul 25;8:37. doi: 10.1186/s13229-017-0153-9. eCollection 2017.
BACKGROUND
The presence of attention-deficit/hyperactive disorder (ADHD) symptoms and impaired attention performance are commonly noted in individuals with autism spectrum disorder (ASD). However, little is known about attention performance in their unaffected siblings. This study aimed to investigate the ADHD-related traits and attention performance in unaffected siblings of probands with autism and Asperger syndrome (AS), as well as the clinical correlates of ADHD-related traits.
METHODS
We assessed the intention, hyperactivity-impulsivity, and oppositional symptoms, and attention profiles of 199 probands with a diagnosis of ASD (122 autism, 77 AS), their unaffected siblings, and 196 typically developing controls (TD) by their parents' reports on the ADHD-related symptoms and the Connors' Continuous Performance Test (CCPT), respectively.
RESULTS
Compared to TD, unaffected siblings of ASD probands were more hyperactive/impulsive and oppositional, particularly unaffected siblings of AS probands. In CCPT, unaffected siblings of AS have intermediate levels of performance between probands with AS and TD on focused attention and sustained attention but were not statistically different from AS probands or TD in these attention profiles. In contrast, unaffected siblings of autism probands have significantly better CCPT performance when compared to autism probands but not to TD. In addition, stereotyped behaviors predicted ADHD-related traits in both sibling groups, but distinctive patterns of other correlates for ADHD-related traits were found between the two sibling groups.
CONCLUSIONS
This work suggested that unaffected siblings of AS, but not autism, have more hyperactive/impulsive traits and a trend of pervasive attention deficits assessed by CCPT which might serve as potential endophenotypes for genetic studies in AS.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT01582256.
背景
注意缺陷/多动障碍（ADHD）症状的存在以及注意力表现受损在自闭症谱系障碍（ASD）个体中较为常见。然而，对于其未受影响的兄弟姐妹的注意力表现知之甚少。本研究旨在调查自闭症和阿斯伯格综合征（AS）先证者未受影响的兄弟姐妹中与ADHD相关的特质和注意力表现，以及与ADHD相关特质的临床相关性。
方法
我们通过父母对ADHD相关症状的报告以及康纳斯连续性能测试（CCPT），分别评估了199名诊断为ASD的先证者（122例自闭症，77例AS）、他们未受影响的兄弟姐妹以及196名正常发育对照（TD）的意向、多动-冲动和对立症状及注意力特征。
结果
与TD相比，ASD先证者未受影响的兄弟姐妹更多动/冲动且对立，尤其是AS先证者未受影响的兄弟姐妹。在CCPT中，AS未受影响的兄弟姐妹在集中注意力和持续注意力方面的表现介于AS先证者和TD之间，但在这些注意力特征方面与AS先证者或TD无统计学差异。相比之下，自闭症先证者未受影响的兄弟姐妹与自闭症先证者相比，CCPT表现显著更好，但与TD相比则不然。此外，刻板行为在两个兄弟姐妹组中均预测了与ADHD相关的特质，但在两个兄弟姐妹组中发现了与ADHD相关特质的其他相关因素的不同模式。
结论
这项研究表明，AS而非自闭症未受影响的兄弟姐妹具有更多多动/冲动特质以及CCPT评估的普遍注意力缺陷趋势，这可能作为AS遗传研究的潜在内表型。
试验注册
ClinicalTrials.gov，NCT01582256。
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