Sleep, Brain Development, and Behavioral Correlates in a Longitudinal Cohort of Children at Risk for ASD

项目摘要 患有自闭症谱系障碍(ASD)的儿童睡眠障碍的可能性是其他儿童的2-3倍 比通常情况下的儿童发育问题更严重。尽管是睡眠的高优先级人群 研究，尽管有证据表明睡眠问题对 健康、行为、情绪和认知，睡眠发生率的增加和临床影响 有自闭症家族史的个体的问题还没有被很好地理解。这一重大公共卫生问题 关注点是我们应用程序的重点，“睡眠、大脑发育和行为在 患有自闭症的儿童的纵向队列“。睡眠启动、昼夜节律等问题， 在学龄儿童的高家庭风险(HR)队列中睡眠不足的情况是 假设在儿童早期大脑和行为发育发生改变。 该建议利用了最近资助的对7-10岁HR儿童的纵向跟踪调查，并 接受过多次MRI和行为评估的ASD(LR)家族风险较低的儿童 从幼年起，通过美国国立卫生研究院自闭症卓越中心的婴儿脑成像研究(IBIS)。这 300名HR儿童的样本包括大约100名在24个月时被诊断为ASD的儿童，大约200名没有ASD的儿童 ASD的诊断，但其结果从典型的发育到发育和 已知的精神障碍在ASD儿童的兄弟姐妹中发生的几率很高，以及100个LR 目前返回接受评估的儿童，包括在学龄期接受核磁共振检查的儿童。一种生物心理社会 儿科睡眠问题模型预测，生物、环境、 行为和精神因素将解释睡眠问题增加的原因 ASD，但尚不清楚睡眠问题是家族性的、内表型的还是特定于疾病的 在这群人中。我们建议：(1)描述昼夜节律紊乱、睡眠持续时间和 家庭中的其他睡眠参数，使用活动记录仪，通过睡眠日记和通过父母验证 行为和医学睡眠问题报告，(2)检查大脑发育轨迹(来自 婴儿期)与学龄期的睡眠问题有关，以及(3)检查纵向 与睡眠相关的行为和发育轨迹以及同时行为 学龄期的问题。增加对神经生物学和发育的理解 ASD患者睡眠问题的特点对开发新的、 可能有助于减少行为和健康的发育敏感型睡眠干预 由于睡眠问题而加剧的问题，并改善了这一弱势群体的结果。

Project Summary Children with autism spectrum disorder (ASD) are 2-3 times more likely to suffer from sleep problems than typically developing children. Despite being a high priority population for sleep research, and despite evidence that sleep problems have pervasive negative consequences for health, behavior, mood, and cognition, the increased occurrence and clinical impact of sleep problems in individuals with a family history of ASD is not well understood. This major public health concern is the focus of our application, “Sleep, Brain Development, and Behavioral Correlates in a Longitudinal Cohort of Children at Risk for ASD”. Problems with sleep initiation, circadian timing, and inadequate amount of sleep in a high familial risk (HR) cohort of school-age children are hypothesized to be preceded by altered brain and behavioral development in early childhood. This proposal leverages a recently funded longitudinal follow-up of 7-10 year-old HR children and children with low familial risk for ASD (LR) who have had multiple MRI and behavior assessments since infancy through the NIH Autism Center of Excellence Infant Brain Imaging Study (IBIS). This sample of 300 HR children includes ~100 diagnosed with ASD at 24 months, ~200 without a diagnosis of ASD but with outcomes ranging from typical development to developmental and psychiatric disorders known to occur at high rates in siblings of children with ASD, and 100 LR children currently returning for assessment, including MRI, during school age. A biopsychosocial model of pediatric sleep problems predicts that some combination of biological, environmental, behavioral and psychiatric factors will account for the increased prevalence of sleep problems in ASD, but it is unknown whether sleep problems are familial, endophenotypic, or disorder-specific in this population. We propose to: (1) characterize circadian disturbances, sleep duration, and other sleep parameters in the home using actigraphy, validated by sleep diary, and through parent report of behavioral and medical sleep problems, (2) examine brain growth trajectories (from infancy) associated with sleep problems in school-age, and (3) examine the longitudinal behavioral and developmental trajectories and concurrent behavior associated with sleep problems in school-age. Increased understanding of the neurobiology and developmental characteristics of sleep problems in ASD has important implications for developing novel, developmentally-sensitive sleep interventions which may help to reduce behavioral and health problems exacerbated by sleep problems and improve outcomes in this vulnerable population.