ANALYSIS OF CO-OCCURRENCE OF AUTISM SPECTRUM DISORDER WITH OTHER NEUROLOGICAL DISORDERS
Objective: The present study explores the co-occurrence of autism spectrum disorder (ASD) with associated disorders such as epilepsy, attention deficit hyperactive disorder (ADHD), Down’s syndrome (DS), and cerebral palsy (CP).
Methods: This cross-sectional study was carried out in special schools of four districts in Karnataka. A total of 49 ASD individuals were identified among 552 developmentally challenged children. ASD individuals were screened for associated neurological disorders and segregated the data as ASD, ASD with epilepsy, ASD-epilepsy-ADHD, ASD with DS, and ASD with CP. The karyotype analysis was carried out for chromosomal anomalies.
Results: It is found that 57% of the individuals showed only ASD features and the remaining 43% shared ASD features with other neurological disorders. Among 43% of comorbidity, 35% of ASD individuals have epilepsy, 2% have epilepsy-ADHD, 4% have DS, and 2% have CP.
Conclusion: This study supports the strong association between ASD with epilepsy, DS, ADHD, and CP. However, the extent of association of ASD with epilepsy is higher than other neurological disorders. As both are complex neurological disorders, they both show intellectual disability and involve multiple genetic factors. The present investigation is the unique and first report of this study region and also supports earlier studies, suggesting that there is an association of ASD with other neurological disorders.
2. Fombonne E, Marcin C, Manero AC, Bruno R, Diaz C, Villalobos M, et al. Prevalence of autism spectrum disorders in Guanajuato, Mexico: The Leon survey. J Autism Dev Disord 2016;46:1669-85.
3. Jiang YH, Yuen RK, Jin X, Wang M, Chen N, Wu X, et al. Detection of clinical relevant genetic variants in autism spectrum disorder by whole-genome sequencing. Am J Hum Genet 2013;93:1-15.
4. Wall DP, Esteban FJ, DeLuca TF, Huyck M, Monaghan T, Medizabal NV, et al. Comparative analysis of neurological disorders focuses genome-wide search for autism genes. Genomics 2009;93:120-9.
5. Wang XZ, Hou M, Zhang D, Zhong N. Molecular screening of FMR1 mutation among autism patients in China. World J Pediatr 2006;2:285-7.
6. Barnby G, Abbott A, Sykes N, Morris A, Weeks DE, Mott R, et al. Candidate-gene screening and association analysis at the autism-susceptibility locus on chromosome 16p: Evidence of association at GRIN2A and ABAT. Am J Hum Genet 2005;76:950-66.
7. Ruble L, Gallagher T. Autism Spectrum Disorders: Primer for Parents and Educators. Bethesda: National Association of School Psychologists; 2004.
8. Pickles A, Starr E, Kazak S, Bolton P, Papanikolaou K, Bailey A, et al. Variable expression of the autism broader phenotype: Findings from extended pedigrees. J Child Psychol Psychiatry 2000;41:491-502.
9. Jeste SS, Tuchman R. Autism spectrum disorder and epilepsy: Two sides of the same coin? J Child Neurol 2015;30:1963-71.
10. Groom MJ, Kochhar P, Hamilton A, Liddle EB, Simeou M, Hollis C. A typical processing of gaze cues and faces explains comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). J Autism Dev Disord 2017;47:1496-509.
11. Nylander L, Holmqvist M, Gustafson L, Gillberg C. Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adult psychiatry. A 20-year register study. Nord J Psychiatry 2012;67:344-50.
12. Kirby RS, Wingate MS, Braun KV, Doenberg NS, Arneson CL, Benedict RE, et al. Prevalence and functioning of children with cerebral palsy in four areas of the United States in 2006: A report from the autism and developmental disabilities monitoring network. Res Dev Disabil 2011;32:462-9.
13. Tang F, Hartz AM, Bauer B. Drug-resistance epilepsy: Multiple hypothesis, few answers. Front Neurol 2017;8:301.
14. Wang J, Lin ZJ, Liu L, Xu HA, Shi YW, Yi YH, et al. Epilepsy-associated genes. Seizure 2017;44:11-20.
15. Tuchman R, Hirtz D, Mamounas LA. NINDS epilepsy and autism spectrum disorders workshop report. Am Acad Neurol 2013;81:1630-6.
16. Christensen J, Vestergaard M, Olsen J, Sidenius P. Validation of epilepsy diagnoses in the Danish national hospital register. Epilepsy Res 2007;75:162-70.
17. Silk TJ, Malpas CB, Beare R, Efron D, Anderson V, Hazell P, et al. A network analysis approach to ADHD symptoms: More than the sum of its parts. PLoS One 2019;14:e0211053.
18. Davis NO, Kollins SH. Treatment for co-occuring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics 2012;9:518-30.
19. Besag F, Gobbi G, Caplan R, Sillanpaa M, Aldenkamp A, Dunn DW. Psychiatric and behavioural disorders in children with epilepsy (ILAE task force report): Epilepsy and ADHD. Epileptic Disord 2016;18:S8-15.
20. Kazemi M, Salehi M, Kheirollahi M. Down syndrome: Current status, challenges, and future perspectives. Int J Mol Cell Med 2016;5:125-33.
21. Dressler A, Perelli V, Bozza M, Bargagna S. The autistic phenotype in down syndrome: Differences in adaptive behaviour versus Down syndrome alone and autistic disorder alone. Funct Neurol 2011;26:151-8.
22. Eyk CL, Corbett MA, Gardner A, Bon BW, Broasbent JL, Harper K, et al. Analysis of 182 cerebral palsy transcriptomes points to dysregulation of trophic signalling pathways and overlap with autism. Transl Psychiatry 2018;8:88.
23. Sillanpaa M, Besag F, Aldenkamp A, Caplan R, Dunn DW, Gobbi G. Psychiatric and behavioural disorders in children with epilepsy (ILAE task force report): Epidemiology of psychiatric/behavioural disorder in children with epilepsy. Epileptic Disord 2016;18:S2-7.
24. Chandrakala E, Nagaraj K. Correlation between autistic endophenotypes and associated risk factors. Indian J Public Health Res Dev 2019;10:242-8.
25. Mehling MH, Tasse MJ. Severity of autism spectrum disorder: Current conceptualization, and transition to DSM-5. J Autism Dev Disord 2016;46:2000-16.
26. Vijayashankar S, Doss U, Damodaran LP, Arumugam G, Sridharan S. Analysis of salivary components to evaluate the pathogenesis of autism in children. Asian J Pharm Clin Res 2014;7:205-11.
27. Besag FM. Epilepsy in patients with autism: Links, risks and treatment challenges. Neuropsych Dis Treat 2018;14:1-10.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.