Sensory Over Responsivity & Anxiety in Youth with Autism

患有自闭症谱系障碍（ASD）的青少年患焦虑和感觉过度反应（SOR）的风险很高，这两种疾病会导致适应行为和社会功能的严重损害，而这与ASD的严重程度无关。虽然新兴的研究表明这两种症状在ASD儿童中存在关联，但对于(1)它们之间的联系机制，如共同的神经学基础，以及(2)这种关联对ASD儿童治疗的影响知之甚少。焦虑和SOR可能具有相似的神经基础，如杏仁核和海马异常，但ASD和SOR患儿的大脑结构和功能尚未得到研究。类似神经基础的发现可能支持对青少年自闭症患者的焦虑和SOR的协调诊断和治疗方法。本研究采用双管齐下的方法来提高对这两种综合征的理解和治疗：首先是一种基础科学方法，以确定焦虑和SOR潜在的常见神经异常；其次是一种治疗设计，以检查焦虑和SOR之间的联系是否具有现实世界的干预意义。参与者将从加州大学洛杉矶分校自闭症研究和治疗中心（CART）招募68名年龄在10-14岁的ASD儿童，在加州大学洛杉矶分校大脑测绘中心进行正在进行的成像研究。在标准化焦虑访谈（约38分）中，高于显著焦虑临界值的儿童将被纳入正在进行的认知行为治疗（CBT）干预，以治疗患有ASD和共病焦虑症的青少年。拟议的研究将检查杏仁核和海马体体积以及大脑对轻度不愉快的感觉刺激的反应，这些刺激与SOR和焦虑症状有关。此外，本研究将测试自闭症和焦虑儿童的SOR症状是否在CBT过程中得到改善，以及SOR的改善是否与焦虑的改善相对应。这项工作将有助于理解自闭症中焦虑和SOR的性质和影响，并可能对这两种相关综合征的治疗方法的发展产生更有效的影响。这些目标与2009年跨机构自闭症协调委员会自闭症谱系障碍研究战略计划的理想目标一致，该计划规定需要对自闭症谱系障碍进行生物行为研究，以识别和描述共同出现的症状。

Youth with autism spectrum disorders (ASD) are at high risk for anxiety and sensory over-responsivity (SOR), which cause significant impairments in adaptive behavior and social functioning independent of ASD severity. While emerging research shows an association between these two syndromes in children with ASD, little is known about (1) the mechanism that links them, such as a common neurological basis, and (2) implications of this association for the treatment of children with ASD. It is possible that anxiety and SOR have a similar neural basis, such as amygdala and hippocampus abnormalities, but the brain structure and function of children with ASD and SOR has not been examined. Findings of a similar neural basis might support a coordinated diagnosis and treatment approach for anxiety and SOR in youth with autism. The proposed study takes a two- pronged approach to improve the understanding and treatment of these two syndromes: the first is a basic science approach to identifying putative common neural abnormalities underlying anxiety and SOR, and the second is a treatment design to examine whether the connection between anxiety and SOR has real-world implications for intervention. Participants will be 68 children with ASD, aged 10-14 years, recruited from the UCLA Center for Autism Research and Treatment (CART) into ongoing imaging studies at the UCLA Brain Mapping Center. Children who are above the cutoff for significant anxiety on a standardized anxiety interview (approximately 38) will be enrolled in an ongoing cognitive-behavioral treatment (CBT) intervention for youth with ASD and comorbid anxiety disorders. The proposed study will examine amygdala and hippocampus volume as well as brain response to mildly unpleasant sensory stimuli in relation to symptoms of SOR and anxiety. Additionally, this study will test whether symptoms of SOR improve over the course of CBT for children with ASD and anxiety, and whether improvements in SOR correspond with improvements in anxiety. This work will contribute to the field by facilitating understanding of the nature and impact of anxiety and SOR in autism, with possible implications for the development of a more effective and efficient treatment approach for these two related syndromes. These aims are consistent with the aspirational goals of the 2009 Interagency Autism Coordinating Committee Strategic Plan for Autism Spectrum Disorder Research, which stipulates the need for biobehavioral studies of ASD to identify and characterize co-occurring symptoms.