Sensory Over Responsivity & Anxiety in Youth with Autism

患有自闭症谱系障碍（ASD）的青少年患有焦虑和感觉过度反应（SOR）的风险很高，这会导致适应行为和社会功能的显著损害，与ASD的严重程度无关。虽然新兴的研究表明这两种综合征在ASD儿童中存在关联，但人们对（1）将它们联系起来的机制知之甚少，例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。焦虑和SOR可能有相似的神经基础，如杏仁核和海马异常，但ASD和SOR儿童的大脑结构和功能尚未得到检查。类似的神经基础的研究结果可能支持一个协调的诊断和治疗方法的焦虑和SOR的青少年自闭症。拟议的研究采取双管齐下的方法来提高对这两种综合征的理解和治疗：第一种是基础科学方法，以确定焦虑和SOR潜在的假定常见神经异常，第二种是治疗设计，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。参与者将是68名年龄在10-14岁之间的ASD儿童，他们从加州大学洛杉矶分校自闭症研究和治疗中心（CART）招募到加州大学洛杉矶分校脑映射中心正在进行的成像研究中。在标准化焦虑访谈中高于显著焦虑临界值（约38）的儿童将参加持续的认知行为治疗（CBT）干预，用于ASD和共病焦虑障碍的青少年。这项研究将检查杏仁核和海马体积以及大脑对与SOR和焦虑症状相关的轻度不愉快感觉刺激的反应。此外，这项研究将测试是否SOR的症状改善与ASD和焦虑的儿童CBT的过程中，以及是否SOR的改善对应于焦虑的改善。这项工作将有助于该领域的焦虑和SOR在自闭症的性质和影响的理解，为这两个相关综合征的发展一个更有效和更高效的治疗方法可能产生的影响。这些目标与2009年机构间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是一致的，该计划规定需要对ASD进行生物行为研究，以识别和表征共同发生的症状。

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.