scholarly journals The influence of common polygenic risk and gene sets on social skills group training response in autism spectrum disorder

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Danyang Li ◽  
Nora Choque-Olsson ◽  
Hong Jiao ◽  
Nina Norgren ◽  
Ulf Jonsson ◽  
...  
Keyword(s):  
Standard Care ◽  
Autism Spectrum ◽  
Care Group ◽  
Group Training ◽  
Common Variants ◽  
Standard Care Group ◽  
Gene Sets ◽  
Social Skills Group ◽  
Skills Group

Abstract Social skills group training (SSGT) is a frequently used behavioral intervention in autism spectrum disorder (ASD), but the effects are moderate and heterogeneous. Here, we analyzed the effect of polygenic risk score (PRS) and common variants in gene sets on the intervention outcome. Participants from the largest randomized clinical trial of SSGT in ASD to date were selected (N = 188, 99 from SSGT, 89 from standard care) to calculate association between the outcomes in the SSGT trial and PRSs for ASD, attention-deficit hyperactivity disorder (ADHD), and educational attainment. In addition, specific gene sets were selected to evaluate their role on intervention outcomes. Among all participants in the trial, higher PRS for ADHD was associated with significant improvement in the outcome measure, the parental-rated Social Responsiveness Scale. The significant association was due to better outcomes in the standard care group for individuals with higher PRS for ADHD (post-intervention: β = −4.747, P = 0.0129; follow-up: β = −5.309, P = 0.0083). However, when contrasting the SSGT and standard care group, an inferior outcome in the SSGT group was associated with higher ADHD PRS at follow-up (β = 6.67, P = 0.016). Five gene sets within the synaptic category showed a nominal association with reduced response to interventions. We provide preliminary evidence that genetic liability calculated from common variants could influence the intervention outcomes. In the future, larger cohorts should be used to investigate how genetic contribution affects individual response to ASD interventions.

scholarly journals The influence of common polygenic risk and gene sets on social skills group training response in autism spectrum disorder

2019 ◽  
Author(s):  
Danyang Li ◽  
Nora Choque-Olsson ◽  
Hong Jiao ◽  
Nina Norgren ◽  
Ulf Jonsson ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Skills ◽  
Autism Spectrum ◽  
Group Training ◽  
Common Variants ◽  
Polygenic Risk ◽  
Gene Sets ◽  
Social Skills Group ◽  
Skills Group

AbstractSocial skills group training (SSGT) is one of the most frequently used behavior interventions in children and adolescents with autism spectrum disorder (ASD). Current evidence suggests that the effects are moderate and heterogeneous. Genetic predisposition could be one of the factors contributing to this heterogeneity. Therefore, we used polygenic risk score (PRS) and gene-set analysis to investigate the association between SSGT response and common variants in autistic individuals. Participants from the largest randomized clinical trial of SSGT in ASD to date were selected for genotyping. Polygenic risk scores (PRSs) for ASD, attention deficit hyperactivity disorder (ADHD), and educational attainment (EA) were calculated, and their associations with the intervention outcome at post-intervention and follow-up were tested using mixed linear model. In addition, thirty-two gene sets within five categories (synaptic, glial, FMRP, glutamate, and mitochondrial) were selected to evaluate their role in the intervention outcome. Individuals with higher PRSs for ASD and ADHD had inferior response after SSGT. After multiple test correction, significant results were kept for higher ADHD PRS at follow-up (β = 6.67, p = 0.016). Five gene sets within synaptic category showed modest association with reduced response to SSGT in ASD. Taken together, we provided preliminary evidence that genetic liability calculated using PRS and common variants in synapse gene sets could influence the outcome of SSGT. Our results hold promise for future research into the genetic contribution to individual response to ASD interventions, and should be validated in larger cohorts.

scholarly journals Rare variants in the outcome of social skills group training for autism

2021 ◽  
Author(s):  
Danyang Li ◽  
Nora Choque Olsson ◽  
Martin Becker ◽  
Abishek Arora ◽  
Hong Jiao ◽  
...  
Keyword(s):  
Social Skills ◽  
Exome Sequencing ◽  
Standard Care ◽  
Rare Variants ◽  
Autism Spectrum ◽  
Individual Response ◽  
Group Training ◽  
Differential Outcomes ◽  
Social Skills Group ◽  
Skills Group

Background Exome sequencing has been proposed as the first-tier genetic testing in autism spectrum disorder (ASD). Here, we performed exome sequencing in autistic individuals with average to high intellectual abilities (N = 207) to identify a molecular diagnosis of ASD and genetic modulators of intervention outcomes following social skills group training (SSGT) or standard care. Methods Within a randomized controlled trial of SSGT, we performed exome sequencing to prioritize variants of clinical significance (VCSs), variants of uncertain significance (VUSs) and generated a pilot scheme to calculate genetic scores representing the genetic load of rare and common variants in the synaptic transmission pathway (GSSyTr and GSSyTc). The association with the primary outcomes (parent-reported autistic traits, Social Responsiveness Scale) was computed using a mixed linear model. Behavioral and genetic features were combined in a machine learning (ML) model to predict the individual response within the cohort. Results In total, 4.4% (n = 9) and 11.3% (n = 23) of the cohort carried VCSs and VUSs, respectively. Compared to non-carriers, individuals with VCS or VUS together tended to have limited improvements of the interventions (β = 9.22; CI (-0.25, 18.70); P = 0.057) and improved significantly less from standard care (β = 9.35; CI (0.70, 18.00); P = 0.036), but not from SSGT (β = -2.50; CI (-13.34, 8.35); P = 0.65). In addition, both GSSyTr and GSSyTc were associated with differential outcomes in standard care and SSGT groups. Our ML model showed the importance of rare variants for outcome prediction. Conclusions Autistic individuals with likely pathogenic rare variants identified by exome sequencing might benefit less from the standard care. SSGT could therefore be of heightened importance for this subgroup. Further studies are needed to understand genetic predisposition to intervention outcomes.

scholarly journals Effectiveness of An Impedance Cardiography Guided Treatment Strategy to Improve Blood Pressure Control in A Real-World Setting: Results from A Pilot Pragmatic Clinical Trial

2021 ◽  
Author(s):  
Luyan Wang ◽  
Yuan Lu ◽  
Hongyi Wang ◽  
Jianlei Gu ◽  
Zheng J. Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Real World ◽  
Treatment Strategy ◽  
Standard Care ◽  
Impedance Cardiography ◽  
Care Group ◽  
Standard Care Group ◽  
Peking University ◽  
The Mean

ABSTRACTBackgroundHypertension is a hemodynamic-related disorder characterized by abnormalities of the cardiac output (CO) and/or systemic vascular resistance (SVR). We hypothesized that selecting antihypertensive therapy based on patients’ hemodynamic profile could improve blood pressure (BP) control more effectively than standard care in hypertensive patients in real-world clinical practice.MethodsWe conducted a pilot single-center, pragmatic randomized trial involving adults with uncontrolled hypertension who sought outpatient care at a hypertension clinic of the Peking University People’s Hospital, the largest teaching hospital of Peking University, in Beijing China, between December 2018 and December 2019. Participants were randomly assigned to the standard care group or the hemodynamic group in a 1:1 ratio. Impedance cardiography (ICG) was performed with all participants to measure hemodynamic parameters. Only physicians in the hemodynamic group were provided with patients’ ICG findings and a computerized clinical decision support of recommended treatment choices based on patients’ hemodynamic profiles. The primary outcomes were the changes in systolic BP (SBP) and diastolic BP (DBP) levels at the follow-up visit 4-12 weeks after baseline. Secondary outcomes included achievement of BP goal of <140/ 90 mmHg and the changes in BP by baseline BP, age, sex, and BMI.ResultsA total 102 adults (mean age was 54±14 years; 41% were women) completed the study. The mean baseline SBP was 150.9 (±11.5) mmHg and mean baseline DBP was 91.1 (±11.3) mmHg. At the follow-up visit, the mean SBP and DBP decreased by 19.9 and 11.3 mmHg in the hemodynamic group, as compared with 12.0 and 4.9 mmHg in the standard care group (P value for difference between groups <0.001 for both SBP and DBP). The proportion of patients achieving BP goal of <140/ 90 mmHg in the hemodynamic group was 67%, as compared with 41% in the standard care group (P=0.017). The hemodynamic group had a larger effect on BP reduction consistently across subgroups by age, sex, BMI, and baseline BP.ConclusionsAn ICG-guided treatment strategy led to greater reductions in BP levels than were observed with standard care in a real-world population of outpatients with hypertension. There is a need for further validation of this strategy for improving blood pressure treatment selection. (Funded by internal research grant from the Peking University People’s Hospital; ClinicalTrials.gov number: NCT04715698.)

scholarly journals Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial

BMJ ◽  
2021 ◽  
pp. n2209
Author(s):  
Michael H McGillion ◽  
Joel Parlow ◽  
Flavia K Borges ◽  
Maura Marcucci ◽  
Michael Jacka ◽  
...  
Keyword(s):  
Standard Care ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Absolute Difference ◽  
Care Group ◽  
Standard Care Group ◽  
Virtual Care ◽  
Randomised Controlled ◽  
At Home

Abstract Objective To determine if virtual care with remote automated monitoring (RAM) technology versus standard care increases days alive at home among adults discharged after non-elective surgery during the covid-19 pandemic. Design Multicentre randomised controlled trial. Setting 8 acute care hospitals in Canada. Participants 905 adults (≥40 years) who resided in areas with mobile phone coverage and were to be discharged from hospital after non-elective surgery were randomised either to virtual care and RAM (n=451) or to standard care (n=454). 903 participants (99.8%) completed the 31 day follow-up. Intervention Participants in the experimental group received a tablet computer and RAM technology that measured blood pressure, heart rate, respiratory rate, oxygen saturation, temperature, and body weight. For 30 days the participants took daily biophysical measurements and photographs of their wound and interacted with nurses virtually. Participants in the standard care group received post-hospital discharge management according to the centre’s usual care. Patients, healthcare providers, and data collectors were aware of patients’ group allocations. Outcome adjudicators were blinded to group allocation. Main outcome measures The primary outcome was days alive at home during 31 days of follow-up. The 12 secondary outcomes included acute hospital care, detection and correction of drug errors, and pain at 7, 15, and 30 days after randomisation. Results All 905 participants (mean age 63.1 years) were analysed in the groups to which they were randomised. Days alive at home during 31 days of follow-up were 29.7 in the virtual care group and 29.5 in the standard care group: relative risk 1.01 (95% confidence interval 0.99 to 1.02); absolute difference 0.2% (95% confidence interval −0.5% to 0.9%). 99 participants (22.0%) in the virtual care group and 124 (27.3%) in the standard care group required acute hospital care: relative risk 0.80 (0.64 to 1.01); absolute difference 5.3% (−0.3% to 10.9%). More participants in the virtual care group than standard care group had a drug error detected (134 (29.7%) v 25 (5.5%); absolute difference 24.2%, 19.5% to 28.9%) and a drug error corrected (absolute difference 24.4%, 19.9% to 28.9%). Fewer participants in the virtual care group than standard care group reported pain at 7, 15, and 30 days after randomisation: absolute differences 13.9% (7.4% to 20.4%), 11.9% (5.1% to 18.7%), and 9.6% (2.9% to 16.3%), respectively. Beneficial effects proved substantially larger in centres with a higher rate of care escalation. Conclusion Virtual care with RAM shows promise in improving outcomes important to patients and to optimal health system function. Trial registration ClinicalTrials.gov NCT04344665 .

scholarly journals Social skills group training in children with autism spectrum disorder: a randomized controlled trial

2018 ◽  
Vol 28 (3) ◽  
pp. 415-424 ◽  
Author(s):  
Vera Dekker ◽  
Maaike H. Nauta ◽  
Marieke E. Timmerman ◽  
Erik J. Mulder ◽  
Lianne van der Veen-Mulders ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Randomized Controlled Trial ◽  
Social Skills ◽  
Controlled Trial ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Group Training ◽  
Randomized Controlled ◽  
Social Skills Group ◽  
Skills Group

scholarly journals Effectiveness of Social Skills Training Groups in Persons with Severe Mental Illness: A Pre–Post Intervention Study

2021 ◽  
pp. 025371762110241
Author(s):  
Priyadarshini Aruldass ◽  
Thamarai Selvi Sekar ◽  
Srikrithika Saravanan ◽  
Reema Samuel ◽  
K. S. Jacob
Keyword(s):  
Social Skills ◽  
Training Program ◽  
Social Skills Training ◽  
Rating Scale ◽  
Skills Training ◽  
Group Training ◽  
Time Points ◽  
Social Skills Group ◽  
Skills Group

Background: The study aimed to evaluate the effectiveness of a social skills training program provided at the occupational therapy unit of a tertiary care center in India. Methods: The study used a pre–post interventional design where 101 consecutive patients with a diagnosis of schizophrenia or bipolar affective disorder, between 18 and 60 years, who provided written informed consent, were assessed on the Vellore Assessment of Social Performance (VASP) during the first week of attendance (baseline). Subsequently, they were enrolled in a six-session social skills group training program for two weeks. They were assessed on the VASP after one week (midterm assessment) and at the end (posttest) of the intervention. A follow-up assessment was done two weeks after cessation of the intervention. The participants were also scored on the Brief Psychiatric Rating Scale (BPRS) at four time points. Results: Repeated measures ANOVA revealed significant differences in the VASP scores between time points, that is, F(baseline, midterm) = −4.34 and P = 0.001; F (baseline, postgroup) = −6.92 and P = 0.001; and F (baseline, follow-up) = −8.71 and P = 0.001. The correlation between the BPRS and VASP scores was also significant at each time point. Conclusion: The social skills group training protocol seems to be effective and feasible for the Indian population. Since conducting multicenter clinical trials might not always be possible in resource-constrained settings, this study might be considered preliminary evidence for context-specific, peer-/family-supported social skills training.

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