Clinical and Immunological Investigations of Subtypes of Autism
The purpose of this study is to learn more about autism and its subtypes. Autism is a developmental disorder in which children have problems with communication and social skills and display restricted interests and repetitive behaviors.
This study has several goals. One aim is to look at types of autism that are known, such as the regressive subtype, (where skills are lost). We will explore whether there is a unique change in immune functioning related to this subtype. Another aim is to serve as one of the sites that will pilot a larger natural history study, entitled Autism Phenome Project. The goal is to further understand autism by identifying other subtypes.
We will look at several types of medical issues that may be related to autism, including immunologic problems. Children will be followed over the course of several years. We aim to capture medical problems that may be related to autism as they develop, and study outcomes in areas such as behavior and language, in order to explore known and new subtypes of autism.
Normally developing children (aged 1) with autism (age 1, and developmental delays other than autism (age 1), may be eligible for this study.
Depending on each child's study group and age, participants may undergo the following tests and procedures:
- Medical and developmental history, physical examination, psychological, cognitive and medical tests to assess symptoms of autism or other developmental disorders, photographs of the child's face, collection of hair, urine and baby teeth samples. If available, hair samples from the baby's first haircut and from the biological mother's hair are also collected.
- Overnight electroencephalogram (EEG): A special cap with electrodes is placed on the child's head to measure brain waves (brain electrical activity) while the child sleeps in the hospital overnight. Healthy volunteers do not undergo this procedure.
- Magnetic resonance imaging (MRI) scan: The child stays in the scanner, lying still for 10 to 15 minutes at a time. Since it may be difficult for the child to lie still, the test may be scheduled for a time when the child is likely to be sleepy, or the child may be sedated.
- Lumbar puncture (for children in the autism). This test and the MRI may be done under sedation.
Follow-up visits are scheduled at different intervals, depending on study group, age and aspect of the study the child is enrolled in. The visits include a short interview session with the child's caregiver and assessment of the child's development and behavior. Some of the assessment measures used during the baseline examination are repeated, including symptoms ratings, behavioral tests and a blood test. For some children, the final visit will include repeats of the medical procedures.
Autism Spectrum Disorders
|Study Design:||Time Perspective: Prospective|
|Official Title:||Clinical and Immunological Investigations of Subtypes of Autism|
- Behavioral profiles [ Time Frame: 6 to 12 months ]
- Immune markers [ Time Frame: 6 to 12 months ]
- Sleep/EEG findings [ Time Frame: 6 to 12 months ]
- Neuroimaging findings [ Time Frame: 6 to 12 months ]
- Other laboratory findings [ Time Frame: 6 to 12 months ]
- Genetic abnormalities [ Time Frame: 6 to 12 months ]
|Study Start Date:||February 22, 2006|
|Estimated Study Completion Date:||March 15, 2017|
The current investigation focuses on finding meaningful subtypes of autism. Our objectives include using comprehensive and longitudinal medical assessments and behavioral testing to find subgroups of children with autism with profiles that comprise distinct biological/behavioral phenotypes.
Specific goals include determining if there is a unique alteration in immune function among autistic children with a regressive clinical course, and identifying autism-specific sleep and electroenchelalogram (EEG) abnormalities, and other potential biomarkers.
We are conducting a longitudinal natural history study of 140 children with autism, 12 to 84 months of age at study entry. We also are following as many as 75 typically developing children, and 50 children with Developmental Delay to serve as age-/sex-matched controls.
Systematic prospective evaluations are being utilized to determine diagnostic and functional outcomes, and evaluate behavioral, medical and immunologic functioning. These evaluations include comprehensive medical history, behavioral assessment, physical and neurologic examination, polysomnography (PSG) and EEG, and blood work for laboratory assays. Baseline evaluations also included MRI and lumbar puncture (the latter was only subjects with autism). In any investigation of behavioral outcomes and potential biomarkers, repeated assessments are necessary to determine whether findings are due to state versus trait alterations. Thus, key elements of the assessments are repeated every 6 to 12 months, depending on the child s age.
Measures of autism symptoms and severity, along with cognitive and adaptive behavior profiles, will be used as behavioral outcome variables.
Results of physical and neurological examinations, genetic testing, EEGs, polysomnograms, MRI scans and laboratory assays of blood and CSF will be tested for their utility as biomarkers of autism s core symptoms or identification of etiologically related subgroups of patients.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00298246
|United States, Maryland|
|National Institutes of Health Clinical Center, 9000 Rockville Pike|
|Bethesda, Maryland, United States, 20892|
|Principal Investigator:||Susan E Swedo, M.D.||National Institute of Mental Health (NIMH)|