Optimal Outcomes in ASD: Adult Functioning, Predictors, and Mechanisms

自闭症谱系障碍 (ASD) 的最佳结果：成人功能、预测因子和机制

基本信息

批准号：
10065523
负责人：
Inge-Marie Eigsti
金额：
$ 64.34万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-01-01 至 2022-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10065523
关键词：
18 year old 21 year old Address Adolescence Adolescent Adult Affect Age Anxiety Attention Attention deficit hyperactivity disorder Brain Brain region Child Childhood Clinical Cohort Studies Data Development Diagnosis Dorsal Early Diagnosis Early identification Employment Face Financial compensation Functional Magnetic Resonance Imaging Functional disorder Gender Gold Grant Homologous Gene Image Impairment Individual Intervention Knowledge Language Lead Left Life Magnetic Resonance Imaging Measures Methods Modeling Motor Network-based Occupational Outcome Outcomes Research Participant Personality Phobias Prospective Studies Research Residual state Rest Risk Seeds Social Functioning Specific qualifier value Symptoms System Task Performances Teenagers Testing Time Study Work autism spectrum disorder autistic children base cognitive control cohort comorbidity early childhood early onset executive function experience follow-up functional outcomes graph theory higher education information processing language impairment language outcome language processing lexical neural circuit neuroimaging neuromechanism novel peer prospective recruit relating to nervous system repetitive behavior research study segregation skills social social communication syntax young adult

项目摘要

Some individuals meet gold-standard clinical criteria for ASD prior to age 5 but end up later in development with no symptoms of ASD, and IQ and adaptive skills in the average range. This study evaluates this “optimal outcome” (OO) in two groups: (1) those who participated in our OO research study as teens, now young adults, allowing us to evaluate how they navigate the difficult transition into independence and young adulthood; and (2) those who were diagnosed by us with ASD at age two and re-evaluated at age four, now in their teens, allowing us to identify which of this cohort has achieved optimal outcome, and thus to identify early predictors of OO. Both cohorts are compared to age-, gender-, and NVIQ-matched individuals with current ASD and with typical development (TD). We hypothesize that the young adults with OO will experience mild delays in adult milestones such as finishing higher education and obtaining competitive employment, along with greater anxiety, especially simple phobias, and ADHD symptoms. We also hypothesize that early childhood predictors of OO will be milder social impairment, higher adaptive skills in social, communication, and motor domains, and fewer repetitive behaviors. We employ fMRI in the second cohort (n=50 per study group, total n=150) to measure the functional connectivity networks that are involved in social and language tasks, and that are observed during resting state, to investigate how neural mechanisms relate to the dramatic symptom change observed in OO. Drawing on prior imaging research, we hypothesize that, compared to both ASD and TD, the OO group will show compensatory (atypical) connectivity of extra-modular prefrontal cognitive control networks and right hemisphere homologues of left-hemisphere language regions during language and social processing and during resting state.

有些人在 5 岁之前就达到了 ASD 的黄金标准临床标准，但最终发育较晚没有 ASD 症状，智商和适应能力处于平均范围内。这项研究评估了这种“最佳状态”。结果”（OO）分为两组：（1）那些在青少年时期参加我们的 OO 研究的人，现在是年轻人，让我们能够评估他们如何度过向独立和青年期的艰难过渡； (2) 那些在两岁时被我们诊断为自闭症谱系障碍并在四岁时重新评估的人，现在已经十几岁了，让我们能够确定这群人中的哪一个已经取得了成果，从而尽早确定 OO 的预测因子。将两个队列与年龄、性别和 NVIQ 匹配的个体进行比较。 ASD 和典型发育 (TD) 我们勇敢地说，患有 OO 的年轻人会经历轻微的症状。成人里程碑的延迟，例如完成高等教育和获得有竞争力的就业，以及具有更大的焦虑，尤其是简单的恐惧症和多动症症状。 OO 的儿童期预测因素将是较轻微的社交障碍、较高的社交、沟通、我们在第二组中采用了功能磁共振成像（fMRI）（每项研究 n=50）。组，总数 n=150）来测量涉及社交和语言的功能连接网络任务，并在静息状态下观察，以研究神经机制如何与根据之前的影像学研究，我们在 OO 中观察到了显着的症状变化。与 ASD 和 TD 相比，OO 组将显示模块外的补偿性（非典型）连接性前额认知控制网络和左半球语言区域的右半球同源物在语言和社会处理期间以及休息状态期间。