Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy.
Int J Environ Res Public Health. 2021 Feb 10;18(4):1693. doi: 10.3390/ijerph18041693.
Neurodevelopmental disorders (NDDs) have been suggested to lie on a gradient continuum, all resulting from common brain disturbances, but with different degrees of impairment severity. This case-control study aimed to assess postural stability against such hypothesis in 104 children/adolescents aged 5-17, of whom 81 had NDDs and 23 were healthy controls. Compared to healthy controls, Autism Spectrum Disorder (ASD) resulted in the most severely impaired neurodevelopmental condition, followed by Attention Deficit Hyperactive Disorder (ADHD) and Tourette Syndrome (TS). In particular, while ASD children/adolescents performed worse than healthy controls in a number of sensory conditions across all parameters, ADHD children/adolescents performed worse than healthy controls only in the sway area for the most complex sensory conditions, when their vision and somatosensory functions were both compromised, and performance in Tourette Syndrome (TS) was roughly indistinguishable from that of healthy controls. Finally, differences were also observed between clinical groups, with ASD children/adolescents, and to a much lesser extent ADHD children/adolescents, performing worse than TS children/adolescents, especially when sensory systems were not operationally accurate. Evidence from this study indicates that poor postural control may be a useful biomarker for risk assessment during neurodevelopment, in line with predictions from the gradient hypothesis.
神经发育障碍（NDDs）被认为存在于一个梯度连续体上，均由共同的大脑紊乱引起，但损害严重程度不同。本病例对照研究旨在针对这一假说，评估 104 名 5-17 岁儿童/青少年的姿势稳定性，其中 81 名患有 NDDs，23 名是健康对照组。与健康对照组相比，自闭症谱系障碍（ASD）导致的神经发育状况受损最严重，其次是注意缺陷多动障碍（ADHD）和妥瑞氏综合征（TS）。具体来说，虽然 ASD 儿童/青少年在所有参数的多种感觉条件下的表现均比健康对照组差，但 ADHD 儿童/青少年仅在最复杂的感觉条件下，当其视觉和躯体感觉功能均受损时，在摇摆区域的表现比健康对照组差，而妥瑞氏综合征（TS）的表现与健康对照组大致相同。最后，在临床组之间也观察到了差异，ASD 儿童/青少年，以及程度较小的 ADHD 儿童/青少年，表现比 TS 儿童/青少年差，尤其是在感觉系统无法正常运作时。本研究的证据表明，姿势控制不佳可能是神经发育过程中风险评估的有用生物标志物，符合梯度假说的预测。
