Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain.
Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain.
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关节过度运动可以将神经疾病与动作障碍和疼痛联系起来。
DOI：
10.3389/fpsyt.2021.786916
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发表时间：
2021
影响因子：
4.7
通讯作者：
Eccles JA
中科院分区：
文献类型：
--
作者：
Csecs JLL;Iodice V;Rae CL;Brooke A;Simmons R;Quadt L;Savage GK;Dowell NG;Prowse F;Themelis K;Mathias CJ;Critchley HD;Eccles JA
自闭症、注意力缺陷多动障碍（ADHD）和抽动障碍（Tourette综合征; TS）是经常共同发生并影响心理、社会和情感过程的神经发育病症。慢性身体症状的可能性增加，包括疲劳和疼痛，也被认识到。关节过度活动的表达，反映了结缔组织的体质变异，预测了对心理症状的易感性以及公认的身体症状。在这里，我们测试了109名患有神经发育疾病的成年人的关节过度活动，自主神经功能障碍和肌肉骨骼症状的患病率增加。将正式诊断为神经发育疾病的成年人（以下简称神经分歧组，n = 109）的全身性关节过度活动（GJH，以下简称过度活动）率与英国一般人群进行比较。将直立不耐受和肌肉骨骼症状的水平与单独的比较组（n = 57）进行比较。仅在神经分化组和对照组中可以确定GJH的年龄特异性截止值。神经发散组表现出高活动率（51%）相比，20%的一般人群和对照人群（17.5%）。使用更严格的年龄特异性截止值，在神经发散组中，这种患病率为28.4%，是对照组（12.5%）的两倍多。与一般人群相比，神经发散组中存在过度活动的比值比为4.51（95%CI 2.17-9.37），女性的比值比大于男性。使用年龄特定截止值，神经分歧组与对照组相比，GJH的比值比为2.84（95%CI 1.16-6.94）。与对照组相比，神经发散型参与者报告了更多的直立不耐受和肌肉骨骼疼痛症状。过度活动关节的数量被发现调解神经分歧和自主神经功能障碍和疼痛症状之间的关系。在神经分歧的成年人中，关节过度活动、自主神经功能障碍和疼痛的表达之间有很强的联系，比对照组更明显。此外，关节活动过度介导神经分歧与自主神经功能障碍和疼痛症状之间的联系。对这种关联的认识和理解的提高可能会加强对神经分歧者核心症状和相关困难的管理，包括共同发生的身体症状，并指导未来的服务提供。
Autism, attention deficit hyperactivity disorder (ADHD), and tic disorder (Tourette syndrome; TS) are neurodevelopmental conditions that frequently co-occur and impact psychological, social, and emotional processes. Increased likelihood of chronic physical symptoms, including fatigue and pain, are also recognized. The expression of joint hypermobility, reflecting a constitutional variant in connective tissue, predicts susceptibility to psychological symptoms alongside recognized physical symptoms. Here, we tested for increased prevalence of joint hypermobility, autonomic dysfunction, and musculoskeletal symptoms in 109 adults with neurodevelopmental condition diagnoses. Rates of generalized joint hypermobility (GJH, henceforth hypermobility) in adults with a formal diagnosis of neurodevelopmental conditions (henceforth neurodivergent group, n = 109) were compared to those in the general population in UK. Levels of orthostatic intolerance and musculoskeletal symptoms were compared to a separate comparison group (n = 57). Age specific cut-offs for GJH were possible to determine in the neurodivergent and comparison group only. The neurodivergent group manifested elevated prevalence of hypermobility (51%) compared to the general population rate of 20% and a comparison population (17.5%). Using a more stringent age specific cut-off, in the neurodivergent group this prevalence was 28.4%, more than double than the comparison group (12.5%). Odds ratio for presence of hypermobility in neurodivergent group, compared to the general population was 4.51 (95% CI 2.17–9.37), with greater odds in females than males. Using age specific cut-off, the odds ratio for GJH in neurodivergent group, compared to the comparison group, was 2.84 (95% CI 1.16–6.94). Neurodivergent participants reported significantly more symptoms of orthostatic intolerance and musculoskeletal skeletal pain than the comparison group. The number of hypermobile joints was found to mediate the relationship between neurodivergence and symptoms of both dysautonomia and pain. In neurodivergent adults, there is a strong link between the expression of joint hypermobility, dysautonomia, and pain, more so than in the comparison group. Moreover, joint hypermobility mediates the link between neurodivergence and symptoms of dysautonomia and pain. Increased awareness and understanding of this association may enhance the management of core symptoms and allied difficulties in neurodivergent people, including co-occurring physical symptoms, and guide service delivery in the future.
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影响因子：
2.6
作者：
Garfinkel, Sarah N.;Tiley, Claire;Critchley, Hugo D.
通讯作者：
Critchley, Hugo D.
DOI：
10.1002/ajmg.c.31546
发表时间：
2017-03-01
影响因子：
3.1
作者：
Fikree, Asma;Chelimsky, Gisela;Aziz, Qasim
通讯作者：
Aziz, Qasim
影响因子：
--
作者：
Allen, Micah;Poggiali, Davide;Kievit, Rogier A
通讯作者：
Kievit, Rogier A
影响因子：
2.7
作者：
Asztely, Karin;Kopp, Svenny;Bergman, Stefan
通讯作者：
Bergman, Stefan
DOI：
10.3390/bs8030035
发表时间：
2018-03-17
期刊：
Behavioral sciences (Basel, Switzerland)
影响因子：
--
作者：
Casanova EL;Sharp JL;Edelson SM;Kelly DP;Casanova MF
通讯作者：
Casanova MF