Epigenetic mechanisms: A possible link between autism spectrum disorders and fetal alcohol spectrum disorders

Children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experience significantly higher rates of sleep disturbances than their typically developing peers. However, little is known about the association between sleep and the cognitive phenotype in these clinical populations. Structural damage affecting cortical and subcortical connectivity occurs as a result of prenatal alcohol exposure in children with FASD, whilst it is believed an abundance of short-range connectivity explains the phenotypic manifestations of childhood ASD. These underlying neural structural and connectivity differences manifest as cognitive patterns, with some shared and some unique characteristics between FASD and ASD. This is the first study to examine sleep and its association with cognition in individuals with FASD, and to compare sleep in individuals with FASD and ASD. We assessed children aged 6–12 years with a diagnosis of FASD (n = 29), ASD (n = 21), and Typically Developing (TD) children (n = 46) using actigraphy (CamNTech Actiwatch 8), digit span tests of working memory (Weschler Intelligence Scale), tests of nonverbal mental age (MA; Ravens Standard Progressive Matrices), receptive vocabulary (British Picture Vocabulary Scale), and a choice reaction time (CRT) task. Children with FASD and ASD presented with significantly shorter total sleep duration, lower sleep efficiency, and more nocturnal wakings than their TD peers. Sleep was significantly associated with scores on the cognitive tests in all three groups. Our findings support the growing body of work asserting that sleep is significant to cognitive functioning in these neurodevelopmental conditions; however, more research is needed to determine cause and effect.

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Prevalence of externalizing disorders and Autism Spectrum Disorders among children with Fetal Alcohol Spectrum Disorder: systematic review and meta-analysis

Biochemistry and Cell Biology ◽

10.1139/bcb-2017-0014 ◽

2018 ◽

Vol 96 (2) ◽

pp. 241-251 ◽

Cited By ~ 17

Author(s):

Shannon Lange ◽

Jürgen Rehm ◽

Evdokia Anagnostou ◽

Svetlana Popova

Keyword(s):

Autism Spectrum Disorders ◽

Neurodevelopmental Disorders ◽

Fetal Alcohol Spectrum Disorder ◽

Externalizing Disorders ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Fetal Alcohol ◽

Oppositional Defiant ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

Owing to their central nervous system impairments, children with Fetal Alcohol Spectrum Disorder (FASD) commonly exhibit externalizing behaviours such as hyperactivity, impulsivity, and (or) delinquency. The purpose of this study was to estimate the prevalence of neurodevelopmental disorders with prominent externalizing behaviours, namely Attention-Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), as well as Autism Spectrum Disorders (ASD) among children with FASD. A comprehensive systematic literature search was performed, followed by disorder-specific random-effects meta-analyses. Of the disorders investigated, ADHD was found to be the most common co-morbid disorder among children with FASD (52.9%), followed by ODD (12.9%), CD (7.0%), and ASD (2.6%). When compared with the general population of the USA, these rates are notably higher: 15 times higher for ADHD, 2 times higher for ASD, 3 times higher for CD, and 5 times higher for ODD. The results call attention to the need for identifying a distinct neurodevelopmental profile to aid in the accurate identification of children with FASD and the discrimination of FASD from certain idiopathic neurodevelopmental disorders.

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Epigenetics in Pediatrics

Pediatrics in Review ◽

10.1542/pir.36.1.14 ◽

2015 ◽

Vol 36 (1) ◽

pp. 14-21

Author(s):

Susan E. Puumala ◽

H. Eugene Hoyme

Keyword(s):

Childhood Leukemia ◽

Clinical Decision Making ◽

Fetal Alcohol Spectrum Disorders ◽

Clinical Decision ◽

Epigenetic Mechanisms ◽

Fetal Alcohol ◽

Pediatric Diseases ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

Epigenetic mechanisms are external modifications of DNA that cause changes in gene function and are involved in many diseases. Specific examples of pediatric diseases with a known or suspected epigenetic component include Beckwith-Wiedemann syndrome, childhood leukemia, allergies, asthma, fetal alcohol spectrum disorders, childhood obesity, and type 2 diabetes mellitus. Currently, epigenetically active treatments are being used to treat childhood leukemia. Potential epigenetically active treatments and preventive regimens are under study for other diseases. Pediatricians need to be aware of the epigenetic basis of disease to help inform clinical decision making in the future.

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