Tye Charlotte, Runicles Abigail K, Whitehouse Andrew J O, Alvares Gail A
Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Front Psychiatry. 2019 Jan 23;9:751. doi: 10.3389/fpsyt.2018.00751. eCollection 2018.
Co-occurring medical disorders and associated physiological abnormalities in individuals with autism spectrum disorder (ASD) may provide insight into causal pathways or underlying biological mechanisms. Here, we review medical conditions that have been repeatedly highlighted as sharing the strongest associations with ASD-epilepsy, sleep, as well as gastrointestinal and immune functioning. We describe within each condition their prevalence, associations with behavior, and evidence for successful treatment. We additionally discuss research aiming to uncover potential aetiological mechanisms. We then consider the potential interaction between each group of conditions and ASD and, based on the available evidence, propose a model that integrates these medical comorbidities in relation to potential shared aetiological mechanisms. Future research should aim to systematically examine the interactions between these physiological systems, rather than considering these in isolation, using robust and sensitive biomarkers across an individual's development. A consideration of the overlap between medical conditions and ASD may aid in defining biological subtypes within ASD and in the development of specific targeted interventions.
自闭症谱系障碍(ASD)患者中同时出现的医学病症及相关生理异常,可能有助于深入了解其病因途径或潜在的生物学机制。在此,我们回顾了一些医学病症,这些病症一再被强调与ASD(癫痫、睡眠以及胃肠和免疫功能)存在最强的关联。我们描述了每种病症的患病率、与行为的关联以及成功治疗的证据。我们还讨论了旨在揭示潜在病因机制的研究。然后,我们考虑每组病症与ASD之间的潜在相互作用,并基于现有证据,提出一个整合这些医学合并症及其潜在共同病因机制的模型。未来的研究应旨在系统地研究这些生理系统之间的相互作用,而不是孤立地考虑它们,在个体发育过程中使用强大而敏感的生物标志物。考虑医学病症与ASD之间的重叠,可能有助于定义ASD中的生物学亚型,并有助于开发特定的靶向干预措施。