The neurology of autism spectrum disorders.
The neurology of autism spectrum disorders.
复制标题
DOI：
10.1097/wco.0b013e3283446450
复制
发表时间：
2011-04
影响因子：
4.8
通讯作者：
Jeste SS
中科院分区：
文献类型：
--
作者：
Jeste SS
自闭症谱系障碍 (ASD) 的神经系统合并症不仅常见，而且还与更严重的临床严重程度相关。这篇综述重点介绍了关于自闭症最常见的三种神经系统并发症的最新文献：运动障碍、睡眠障碍和癫痫。自闭症谱系障碍的运动障碍表现为迟缓和缺陷，粗大和精细运动领域存在迟缓，实践、协调和步态存在缺陷，所有这些都会影响其他认知和行为领域。高达 83% 的 ASD 儿童会出现睡眠障碍，尤其是失眠，最近的研究已开始探索这种障碍的潜在生化和行为基础，这为治疗研究提供了支持。据报道，多达三分之一的自闭症谱系障碍儿童患有癫痫，新的研究重点是确定这种关联的遗传原因。更好地表征这些神经合并症的表型、发育轨迹和潜在的病理生理学将使我们能够定义自闭症谱系内的神经内表型。未来的研究必须前瞻性地调查这些合并症的出现，以确定它们是否是自闭症谱系障碍的因果途径，或者是否反映了该疾病的副现象。由于癫痫和睡眠障碍可以治疗，并且可能对自闭症谱系障碍的行为和认知异常产生重大影响，因此它们的识别具有很高的临床相关性。
Neurological comorbidities in autism spectrum disorders (ASD) are not only common, but they are also associated with more clinical severity. This review highlights the most recent literature on three of autism’s most prevalent neurological comorbidities: motor impairment, sleep disorders, and epilepsy. Motor impairment in ASD manifests as both delays and deficits, with delays found in gross and fine motor domains and deficits found in praxis, coordination, and gait, all of which affect other cognitive and behavioral domains. Sleep disorders, especially insomnia, occur in up to 83% of children with ASD and recent studies have begun to explore the underlying biochemical and behavioral basis of the impairment, which has bolstered treatment studies. Epilepsy is reported in up to one-third of children with ASD, and new studies have focused on identifying the genetic causes of this association. Better characterization of the phenotype, developmental trajectory, and underlying pathophysiology of these neurological comorbidities will enable us to define neurological endophenotypes within the autism spectrum. Future studies must investigate the emergence of these comorbidities prospectively in order to determine whether they lie on the causal pathway to ASD or whether they reflect epiphenomena of the disorder. Since epilepsy and sleep disorders can be treated and may contribute significantly to behavioral and cognitive abnormalities in ASD, their identification is of high clinical relevance.