Burstein Or, Geva Ronny
Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.
Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel.
Front Integr Neurosci. 2021 Nov 10;15:759614. doi: 10.3389/fnint.2021.759614. eCollection 2021.
Autism spectrum disorders (ASD) have long-term implications on functioning at multiple levels. In this perspective, we offer a brainstem-informed autism framework (BIAF) that traces the protracted neurobehavioral manifestations of ASD to early life brainstem dysfunctions. Early life brainstem-mediated markers involving functions of autonomic/arousal regulation, sleep-wake homeostasis, and sensorimotor integration are delineated. Their possible contributions to the early identification of susceptible infants are discussed. We suggest that the BIAF expands our multidimensional understanding of ASD by focusing on the early involvement of brainstem systems. Importantly, we propose an integrated BIAF screener that brings about the prospect of a sensitive and reliable early life diagnostic scheme for weighing the risk for ASD. The BIAF screener could provide clinicians substantial gains in the future and may carve customized interventions long before the current DSM ASD phenotype is manifested using dyadic co-regulation of brainstem-informed autism markers.
自闭症谱系障碍（ASD）在多个层面上对功能有着长期影响。从这个角度出发，我们提出了一个基于脑干的自闭症框架（BIAF），该框架将ASD长期的神经行为表现追溯到早期生活中的脑干功能障碍。文中阐述了涉及自主神经/唤醒调节、睡眠-觉醒稳态和感觉运动整合功能的早期生活脑干介导指标。讨论了它们对易患婴儿早期识别的可能贡献。我们认为，BIAF通过关注脑干系统的早期参与，扩展了我们对ASD的多维度理解。重要的是，我们提出了一种综合的BIAF筛查工具，这为制定一个敏感且可靠的早期生活诊断方案以评估ASD风险带来了希望。BIAF筛查工具未来可为临床医生带来显著收益，并且可能在当前DSM ASD表型出现之前很久，就利用基于脑干的自闭症指标的二元共同调节来制定定制化干预措施。
