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患有自闭症谱系障碍和神经发育倒退的儿童在24个月随访后呈现出严重的模式。

Children With Autism Spectrum Disorder and Neurodevelopmental Regression Present a Severe Pattern After a Follow-Up at 24 Months.

作者信息

Martin-Borreguero Pilar, Gómez-Fernández Antonio Rafael, De La Torre-Aguilar Maria Jose, Gil-Campos Mercedes, Flores-Rojas Katherine, Perez-Navero Juan Luis

机构信息

Unit of Psychology and Paediatric Psychiatry, Reina Sofia University Hospital, Cordoba, Spain.

Department of Paediatrics, Infanta Margarita Hospital, Cabra, Córdoba, Spain.

出版信息

Front Psychiatry. 2021 Mar 26;12:644324. doi: 10.3389/fpsyt.2021.644324. eCollection 2021.

Abstract

This study examined the presence of neurodevelopmental regression and its effects on the clinical manifestations and the severity of autism spectrum disorder (ASD) in a group of children with autism compared with those without neurodevelopmental regression at the time of initial classification and subsequently. ASD patients were classified into two subgroups, neurodevelopmental regressive (AMR) and non-regressive (ANMR), using a questionnaire based on the Autism Diagnostic Interview-Revised test. The severity of ASD and neurodevelopment were assessed with the , and (PDDBI) and with the Battelle Developmental Inventory tests at the beginning of the study and after 24 months of follow-up. Fifty-two patients aged 2-6 years with ASD were included. Nineteen were classified with AMR, and 33 were classified with ANMR. The AMR subgroup presented greater severity of autistic symptoms and higher autism scores. Additionally, they showed lower overall neurodevelopment. The AMR subgroup at 24 months had poorer scores on the Battelle Developmental Inventory test in the following areas: Total personal/social ( < 0.03), Total Motor ( < 0.04), Expressive ( < 0.01), and Battelle Total ( < 0.04). On the PDDBI test, the AMR subgroup had scores indicating significantly more severe ASD symptoms in the variables: ritual score ( < 0.038), social approach behaviors ( < 0.048), expressive language ( < 0.002), and autism score ( < 0.003). ASD patients exhibited a set of different neurological phenotypes. The AMR and ANMR subgroups presented different clinical manifestations and prognoses in terms of the severity of autistic symptoms and neurodevelopment.

摘要

本研究调查了一组自闭症儿童中神经发育倒退的存在情况及其对自闭症谱系障碍(ASD)临床表现和严重程度的影响,并与初始分类时及之后无神经发育倒退的儿童进行比较。使用基于《自闭症诊断访谈修订版》测试的问卷,将ASD患者分为两个亚组:神经发育倒退型(AMR)和非倒退型(ANMR)。在研究开始时和随访24个月后,使用《儿科发育障碍评定量表》(PDDBI)和《巴特尔发育量表》测试评估ASD的严重程度和神经发育情况。纳入了52名年龄在2至6岁的ASD患者。其中19名被分类为AMR,33名被分类为ANMR。AMR亚组表现出更严重的自闭症症状和更高的自闭症评分。此外,他们的整体神经发育水平较低。AMR亚组在24个月时,在《巴特尔发育量表》测试的以下方面得分较低:个人/社交总分(P<0.03)、运动总分(P<0.04)、表达能力(P<0.01)和巴特尔总分(P<0.04)。在PDDBI测试中,AMR亚组在以下变量中的得分表明ASD症状明显更严重:仪式行为得分(P<0.038)、社交接近行为(P<0.048)、表达性语言(P<0.002)和自闭症评分(P<0.003)。ASD患者表现出一组不同的神经学表型。AMR和ANMR亚组在自闭症症状严重程度和神经发育方面表现出不同的临床表现和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b2e/8032949/726fb073a0b8/fpsyt-12-644324-g0001.jpg

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