The differential impact of oxytocin receptor (OXTR) genotypes on the risk of autism spectrum disorder (ASD) and resulting social communication deficits

Background: Autism spectrum disorder (ASD) is multifactorial and is likely the result of complex interactions between multiple environmental and genetic factors. Recently, it has been suggested that each symptom cluster of the disorder, such as poor social communication, may be mediated by different genetic influences. Genes in the oxytocin pathway, which mediates social behaviours in humans, have been studied with single nucleotide polymorphisms (SNPs) in the oxytocin receptor gene (OXTR) being implicated in ASD. This thesis examines the presence of different oxytocin receptor genotypes, and their associations with ASD and resulting social communication deficits. Methods: The relationship between four OXTR variants and ASD was evaluated in 607 ASD simplex (SPX) families. Cases were compared to their unaffected siblings using a conditional logistic approach. Odds ratios and associated 95 percent confidence intervals were obtained. A second sample of 235 individuals with a diagnosis of ASD was examined to evaluate whether these four OXTR variants were associated with social communication scores on the Autism Diagnostic Interview – Revised (ADI-R). Parameter estimates and associated 95 percent confidence intervals were generated using a linear regression approach. Multiple testing issues were addressed using false discovery adjustments. Results: The rs53576 AG genotype was significantly associated with a lower risk of ASD (OR = 0.707, 95% CI: 0.512-0.975). A single genotype (AG) provided by the rs2254298 marker was found to be significantly associated with higher social communication scores (Parameter estimate = 1.833, SE = 0.762, p = 0.0171). This association was also seen in a Caucasian only and mothers as the respondent samples. No association was significant following false discovery rate adjustments. Conclusion: The findings from these studies provide limited support for the role of OXTR SNPs in ASD, especially in social communication skills. The clinical significance of these associations remains unknown, however, it is likely that these associations do not play a role in the severity of symptoms associated with ASD. Rather, they may be important in the appearance of social deficits due to the rs2254298 markers association with enlarged amygdalas.

Understanding the genetic basis of phenotype variability in individuals with neurocognitive disorders

Thesis (Ph.D.)--University of Washington, 2016-06

Social Cognition, Negative Symptoms and Psychosocial Functioning in Schizophrenia.

Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of social cognition dysfunction in schizophrenia patients’ daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocognition. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs—social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.

Error analyses reveal contrasting deficits in “theory of mind”: neuropsychological evidence from a 3-option false belief task

Perspective taking is a crucial ability that guides our social interactions. In this study, we show how the specific patterns of errors of brain-damaged patients in perspective taking tasks can help us further understand the factors contributing to perspective taking abilities. Previous work (e.g., Samson, Apperly, Chiavarino, & Humphreys, 2004; Samson, Apperly, Kathirgamanathan, & Humphreys, 2005) distinguished two components of perspective taking: the ability to inhibit our own perspective and the ability to infer someone else’s perspective. We assessed these components using a new nonverbal false belief task which provided different response options to detect three types of response strategies that participants might be using: a complete and spared belief reasoning strategy, a reality-based response selection strategy in which participants respond from their own perspective, and a simplified mentalising strategy in which participants avoid responding from their own perspective but rely on inaccurate cues to infer the other person’s belief. One patient, with a self-perspective inhibition deficit, almost always used the reality-based response strategy; in contrast, the other patient, with a deficit in taking other perspectives, tended to use the simplified mentalising strategy without necessarily transposing her own perspective. We discuss the extent to which the pattern of performance of both patients could relate to their executive function deficit and how it can inform us on the cognitive and neural components involved in belief reasoning.

Testosterone and attention deficits as possible mechanisms underlying impaired emotion recognition in intimate partner violence perpetrators

Several studies have reported impairments in decoding emotional facial expressions in intimate partner violence (IPV) perpetrators. However, the mechanisms that underlie these impaired skills are not well known. Given this gap in the literature, we aimed to establish whether IPV perpetrators (n = 18) differ in their emotion decoding process, attentional skills, and testosterone (T), cortisol (C) levels and T/C ratio in comparison with controls (n = 20), and also to examine the moderating role of the group and hormonal parameters in the relationship between attention skills and the emotion decoding process. Our results demonstrated that IPV perpetrators showed poorer emotion recognition and higher attention switching costs than controls. Nonetheless, they did not differ in attention to detail and hormonal parameters. Finally, the slope predicting emotion recognition from deficits in attention switching became steeper as T levels increased, especially in IPV perpetrators, although the basal C and T/C ratios were unrelated to emotion recognition and attention deficits for both groups. These findings contribute to a better understanding of the mechanisms underlying emotion recognition deficits. These factors therefore constitute the target for future interventions.

A pain neuroscience education program for fibromyalgia patients with cognitive deficits: a case series

Trabalho apresentado na IFOMPT Conference, 4 a 8 de julho de 2016, Glasgow, Escócia

Indigofera tinctoria Linn (Fabaceae) attenuates cognitive and behavioral deficits in scopolamine-induced amnesic mice

Purpose: To investigate the cognition-enhancing effects of aqueous extract of Indigofera tinctoria Linn (ITE, Fabaceae) in experimental amnesic mice. Methods: Scopolamine (2 mg/kg, i.p.) was used to induce amnesia in mice. The cognitive-enhancing activity of the ITE (5, 10 and 20 μg/mL) was studied by passive avoidance response, elevated plus maze and Y-maze behavioral paradigm in normal and scopolamine-induced amnesic mice. Antioxidant activities were also determined based on the ability of ITE to inhibit lipid peroxide, superoxide and hydroxyl radicals. Results: Scopolamine-induced cognitive deficits were significantly reversed by ITE (p < 0.001 at 20 mg/kg) in a dose-dependent fashion in all the behavioral paradigms tested. Furthermore, ITE dosedependently scavenged lipid peroxide, superoxide and hydroxyl free radicals with 50 % inhibition concentration (IC50) of 7.28 ± 0.37, 5.25 ± 0.28 and 7.62 ± 0.43 μg/mL, respectively. Conclusion: ITE possesses cognitive-enhancing properties in amnesic mice due to its potent antioxidant action.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

Caracterización de la función cognitiva de niños con síndrome de down de 5 a 12 años en la ciudad de Bogotá

Los niños que padecen trisomía 21 poseen una serie de características físicas, neurológicas y neuropsicológicas específicas, las cuales han sido investigadas a profundidad en diferentes países, de lo cual se han desarrollado protocolos de evaluación para estos niños acorde a su nacionalidad (García, 2010). A pesar de que Colombia es uno de los países en los cuales el síndrome de Down se presenta con mayor frecuencia, hasta la fecha, no se encuentran estudios que enfaticen en las habilidades neuropsicológicas de esta población específica, por lo cual no se han desarrollado protocolos de evaluación adecuados para los niños con síndrome este síndrome. Esta investigación se llevó acabo con una población de 88 niños a los cuales se les aplicó el inventario de desarrollo BATTELLE, y se identificó que los niños con síndrome Down de 5 a 12 años obtienen un puntaje que se encuentra en 4 desviaciones estándar por debajo de la media típica. Lo anterior demuestra una característica específica de esta población en cuanto a patrones de desarrollo en las cuales, se evidencia dificultad más importante en las área cognición y de la comunicación expresiva. Con respecto a los intervalos de edad se identificó que a lo largo de estos el desempeño en las áreas evaluadas decrece. esto puede estar relacionado con la mayor complejidad de los hitos del desarrollo para una edad esperada. Debido a que los hitos del desarrollo esperados varían a lo largo de los periodos del ciclo vital del ser humano, estos tienden a aumentar su complejidad en etapas del desarrollo más avanzados; como estos niños poseen una serie de dificultades en las funciones ejecutivas y cognición, no lograrán alcanzar dichos hitos del desarrollo.

Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

A national building products inventory

Australia has no nationally accepted building products life cycle inventory (LCI) database for use in building Ecologically Sustainable Development (ESD) assessment (BEA) tools. More information about the sustainability of the supply chain is limited by industry’s lack of real capacity to deliver objective information on process and product environmental impact. Recognition of these deficits emerged during compilation of a National LCI database to inform LCADesign, a prototype 3 dimensional object oriented computer aided design (3-D CAD) commercial building design tool. Development of this Australian LCI represents 24 staff years of effort here since 1995. Further development of LCADesign extensions is proposed as being essential to support key applications demanded from a more holistic theoretical framework calling for modules of new building and construction industry tools. A proposed tool, conceptually called LCADetails, is to serve the building product industries own needs as well as that of commercial building design amongst other industries’ prospective needs. In this paper, a proposition is examined that the existing national LCI database should be further expanded to serve Australian building product industries’ needs as well as to provide details for its client-base from a web based portal containing a module of practical supply and procurement applications. Along with improved supply chain assessment services, this proposed portal is envisaged to facilitate industry environmental life cycle improvement assessment and support decision-making to provide accredited data for operational reporting capabilities, load-based reasoning as well as BEA applications. This paper provides an overview of developments to date, including a novel 3-D CAD information and communications technology (ICT) platform for more holistic integration of existing tools for true cost assessment. Further conceptualisation of future prospects, based on a new holistic life cycle assessment framework LCADevelop, considering stakeholder relationships and their need for a range of complementary tools leveraging automated function off such ICT platforms to inform dimensionally defined operations for such as automotive, civil, transport and industrial applications are also explored.

Imaginary relish and exquisite torture : the elaborated intrusion theory of desire

The authors argue that human desire involves conscious cognition that has strong affective connotation and is potentially involved in the determination of appetitive behavior rather than being epiphenomenal to it. Intrusive thoughts about appetitive targets are triggered automatically by external or physiological cues and by cognitive associates. When intrusions elicit significant pleasure or relief, cognitive elaboration usually ensues. Elaboration competes with concurrent cognitive tasks through retrieval of target related information and its retention in working memory. Sensory images are especially important products of intrusion and elaboration because they simulate the sensory and emotional qualities of target acquisition. Desire images are momentarily rewarding but amplify awareness of somatic and emotional deficits. Effects of desires on behavior are moderated by competing incentives, target availability, and skills. The theory provides a coherent account of existing data and suggests new directions for research and treatment.

A 1H-MRS investigation of the medial temporal lobe in antipsychotic-naïve and early-treated first episode psychosis

Schizophrenia is associated with significant brain abnormalities, including changes in brain metabolites as measured by proton magnetic resonance spectroscopy (MRS). What remains unclear is the extent to which these changes are a consequence of the emergence of psychotic disorders or the result of treatment with antipsychotic medication. We assessed 34 patients with first episode psychosis (15 antipsychotic naïve) and 19 age- and gender-matched controls using short-echo MRS in the medial temporal lobe bilaterally. Overall, there were no differences in any metabolite, regardless of treatment status. However, when the analysis was limited to patients with a diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, significant elevations of creatine/phosphocreatine (Cr/PCr) and myo-inositol (mI) were found in the treated group. These data indicate a relative absence of temporal lobe metabolic abnormalities in first episode psychosis, but suggest that some treatment-related changes in mI might be apparent in patients with schizophrenia-spectrum diagnoses. Seemingly illness-related Cr/PCr elevations were also specific to the diagnosis of schizophrenia-spectrum disorder and seem worthy of future study.

Corneal confocal microscopy : a novel noninvasive means to diagnose neuropathy in patients with Fabry disease

ABSTRACT: Neuropathy is a cause of significant disability in patients with Fabry disease, yet its diagnosis is difficult. In this study we compared the novel noninvasive techniques of corneal confocal microscopy (CCM) to quantify small-fiber pathology, and non-contact corneal esthesiometry (NCCA) to quantify loss of corneal sensation, with established tests of neuropathy in patients with Fabry disease. Ten heterozygous females with Fabry disease not on enzyme replacement therapy (ERT), 6 heterozygous females, 6 hemizygous males on ERT, and 14 age-matched, healthy volunteers underwent detailed quantification of neuropathic symptoms, neurological deficits, neurophysiology, quantitative sensory testing (QST), NCCA, and CCM. All patients with Fabry disease had significant neuropathic symptoms and an elevated Mainz score. Peroneal nerve amplitude was reduced in all patients and vibration perception threshold was elevated in both male and female patients on ERT. Cold sensation (CS) threshold was significantly reduced in both male and female patients on ERT (P < 0.02), but warm sensation (WS)and heat-induced pain (HIP) were only significantly increased in males onERT (P<0.01). However, corneal sensation assessed withNCCAwas significantly reduced in female (P < 0.02) and male (P < 0.04) patients on ERT compared with control subjects. According to CCM, corneal nerve fiber and branch density was significantly reduced in female (P < 0.03) and male (P < 0.02) patients on ERT compared with control subjects. Furthermore, the severity of neuropathic symptoms and the neurological component of the Mainz Severity Score Index correlated significantly with QSTand CCM. This study shows that CCM and NCCA provide a novel means to detect early nerve fiber damage and dysfunction, respectively, in patients with Fabry disease.