Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia 30329-4010, USA.
Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30329-4010, USA.
Medicina (B Aires). 2022 Feb 2;82 Suppl 1(Suppl 1):33-36.
This review focuses on four interrelated teams and research lines that form the basis for new research on the pathogenesis of autism spectrum disorder (ASD) at the Marcus Autism Center, in Atlanta (US). These themes probe typical social behavior and brain development from birth, and disruptions thereof in babies later diagnosed with ASD. These four themes are: to leverage lifetime maximal neuroplasticity; to test the hypothesis that developmental disruption of early-emerging mechanisms of socialization drives pathogenesis and results in autistic social disability; the focus on the infant-caregiver dyad, and the iterative context associated with mutually reinforcing and adapted social and communitive inter-action, or emerging cycles of social contingency, from the first days and weeks of life; and the study of time-varying neurodevelopmental transitions in social behavior from experience-expectant (reflexive, endogenous) and subcortically-guided to experience-dependent (caregiver- and reward-driven) and cortically-guided, a transition that our work suggests is uniquely disrupted in babies later diagnosed with ASD. This science is opening a world of opportunities to optimize children's outcomes despite the genetic liabilities that they are born with. It provides the scientific grounding for new community-viable solutions for increasing access to early interventions using treatments that scaffold and strengthen infant-caregiver interactions, which is the platform for early brain development.
这篇综述聚焦于亚特兰大马库斯自闭症中心(美国)的四个相互关联的团队和研究方向,它们为自闭症谱系障碍(ASD)发病机制的新研究奠定了基础。这些主题从婴儿期开始探究典型的社会行为和大脑发育,以及后来被诊断为 ASD 的婴儿的这些方面的中断。这四个主题是:利用终生最大的神经可塑性;测试这样的假设,即早期出现的社会化机制的发育中断驱动发病机制,并导致自闭症的社交障碍;关注婴儿-照顾者对子,以及与相互增强和适应的社交和交流相互作用相关的迭代环境,或从生命的头几天和几周开始出现的社交偶然性的循环;以及研究社会行为中从经验预期(反射性、内源性)和皮质下引导到经验依赖(照顾者和奖励驱动)和皮质引导的神经发育过渡随时间的变化,我们的工作表明,这种过渡在后来被诊断为 ASD 的婴儿中是独特地中断的。这项科学正在为优化儿童的预后开辟一个机会的世界,尽管他们天生就存在遗传缺陷。它为使用支架和加强婴儿-照顾者互动的治疗方法增加早期干预机会的新的可行的社区解决方案提供了科学依据,这是早期大脑发育的平台。