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执行功能、适应技能、情绪和行为概况:自闭症谱系障碍与苯丙酮尿症的比较

Executive functioning, adaptive skills, emotional and behavioral profile: A comparison between autism spectrum disorder and phenylketonuria.

作者信息

Trimarco Barbara, Manti Filippo, Nardecchia Francesca, Melogno Sergio, Testa Mara, Meledandri Giovanni, Carducci Claudia, Penge Roberta, Leuzzi Vincenzo

机构信息

Department of Human Neuroscience, "Sapienza" University of Rome, Via dei Sabelli 108, 00185 Rome, Italy.

Department of Human Science, "Università degli Studi Guglielmo Marconi", Via Plinio 44, 00193 Rome, Italy.

出版信息

Mol Genet Metab Rep. 2020 Mar 9;23:100577. doi: 10.1016/j.ymgmr.2020.100577. eCollection 2020 Jun.

Abstract

INTRODUCTION

Influential theories maintain that some of Autism Spectrum Disorder (ASD) core symptoms may arise from deficits in executive functions (EF). EF deficits are also considered a neuropsychological marker of early treated individuals with phenylketonuria (PKU). Aims of this study were: to verify the occurrence and patterns of specific EF impairments in both clinical groups; to explore the coexistence of EF alterations with adaptive, behavioral and emotional problems in each clinical condition.

MATERIAL AND METHODS

We assessed EF, adaptive, behavioral and emotional profile in 21 participants with ASD, 15 early treated PKU individuals, comparable for age and IQ, and 14 controls, comparable for age to the clinical groups (age range: 7-14 years).

RESULTS

ASD and PKU participants presented two different, but partially overlapping patterns of EF impairment. While ASD participants showed a specific deficit in cognitive flexibility only, PKU individuals showed a more extensive impairment in EF with a weaker performance in two core EF domains (inhibition, cognitive flexibility) as compared to healthy controls. Psychological and adaptive profile was typical in PKU participants, while ASD participants experienced behavioral (externalizing symptoms), emotional (internalizing symptoms) and adaptive disorders (general, practical, social domains).

CONCLUSIONS

Present results support the view of a relative disengagement of adaptive and emotional-behavioral profile with respect to EF skills and suggest that other dysfunctions contribute to the multidimensional phenotype of ASD participants.

摘要

引言

有影响力的理论认为,自闭症谱系障碍(ASD)的一些核心症状可能源于执行功能(EF)缺陷。EF缺陷也被认为是早期接受治疗的苯丙酮尿症(PKU)患者的神经心理学标志物。本研究的目的是:验证两个临床组中特定EF损伤的发生情况和模式;探讨在每种临床情况下EF改变与适应性、行为和情绪问题的共存情况。

材料与方法

我们评估了21名ASD参与者、15名早期接受治疗的PKU患者(年龄和智商匹配)以及14名对照组(年龄与临床组匹配,年龄范围:7 - 14岁)的EF、适应性、行为和情绪状况。

结果

ASD和PKU参与者呈现出两种不同但部分重叠的EF损伤模式。ASD参与者仅在认知灵活性方面存在特定缺陷,而PKU患者的EF损伤更为广泛,与健康对照组相比,在两个核心EF领域(抑制、认知灵活性)表现较弱。PKU参与者的心理和适应性状况较为典型,而ASD参与者则经历了行为(外化症状)、情绪(内化症状)和适应性障碍(一般、实践、社会领域)。

结论

目前的结果支持了关于适应性和情绪 - 行为状况相对于EF技能相对分离的观点,并表明其他功能障碍导致了ASD参与者的多维表型。

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