Autism in adults leads to many health problems

This article discusses how autism in adults can result in many other health problems.

Autism apparently isn't a stand-alone disorder, with new research revealing that adults with autism often face a host of mental and physical illnesses.

Kaiser Permanente researchers found that nearly all medical conditions are significantly more common in adults with autism spectrum disorders than those without, ranging from depression to gastrointestinal problems to obesity. Notably, however, adults with autism are much less likely to smoke or use alcohol than other adults, and cancer rates are similar.

"Some of these conditions we've seen in children with autism, so we expected higher rates of anxiety and depression, and some of the medical disorders, such as gastrointestinal disturbances, in adults," said study author Lisa Croen, director of the Kaiser Permanente Autism Research Program in Oakland, Calif.

"That's been reported for a long time in children, so we're not surprised to see those continue to be elevated," she added. "But we were surprised by the magnitude of what we found."

The study is scheduled to be presented Thursday at the International Meeting for Autism Research in Atlanta. Research presented at scientific conferences typically has not been peer-reviewed or published and results are considered preliminary.

Diagnosed in about 1 in 68 American children, autism spectrum disorder is the fastest-growing serious developmental disability in the United States, according to the advocacy and research organization Autism Speaks.

The disorder can be mild or severe, but symptoms typically include social and communication difficulties and repetitive behaviors.

Croen and her colleagues examined medical records from 2008 to 2012, and compared the prevalence of psychiatric, behavioral and medical diagnoses among 2,100 adults with an autism spectrum disorder to 21,000 adults without the disorder.

Adults diagnosed with an autism spectrum disorder had markedly higher rates of mental health problems than the other adults:

• Depression (38 percent versus 17 percent)
• Anxiety (39 percent versus 18 percent)
• Bipolar disorder (30 percent versus 9 percent)
• Suicide attempts (1.6 percent versus 0.3 percent)

People with autism spectrum disorders were also more likely than adults without the disorder to have physical ailments, such as:

• Diabetes (6 percent versus 4 percent)
• Gastrointestinal disorders (47 percent versus 38 percent)
• Epilepsy (12 percent versus 1 percent)
• Sleep disorders (19 percent versus 10 percent)
• High cholesterol (26 percent versus 18 percent)
• High blood pressure (27 percent versus 19 percent)
• Obesity (27 percent versus 16 percent)

"What the data show is really an extension of what we've learned already of children and adolescents with autism," said Dr. Paul Wang, senior vice president and head of medical research for Autism Speaks, who wasn't involved in the study. "It's not just a brain disorder -- it's really a disorder that affects the whole body. And this shows that these problems don't go away."

Croen said that many possible reasons exist for the wide gap in mental and physical ailments suffered by adults with autism, including a potential genetic basis. But the "core impairments" of those with autism -- such as communication problems and heightened sensitivity to touch -- can also make it difficult for them to be properly examined by clinicians, she said.

"People with autism often have very selective eating and their nutrition suffers," Croen added. "Their social impairments can lead to isolation, which leads to a lack of exercise. So some lifestyle factors can create more unhealthy lifestyles."

Social isolation may also explain why adults with autism are less likely to drink alcohol or smoke, noted Croen, also a senior research scientist at Kaiser Permanente Northern California Division of Research.

"Smoking and drinking are more social behaviors, especially in young people," she said. "Or, that's how it gets started. These young people with autism are out of the mainstream."

Croen and Wang agreed that autism researchers should extend their focus beyond the brain to multiple bodily systems as well as examine the transition from pediatric to adult health care.

"I hope these findings raise awareness among the medical community and others that adults with autism have a really high burden of medical and psychiatric conditions, much more than people think," Croen said. "There's a real need for doctors to be educated about autism and the characteristics of these adults so they can provide adequate and effective care."

Read more here

All about sleepwalking

This article discusses sleepwalking, including the science behind sleepwalking.

Also known as somnambulism, sleepwalking has been described in medical literature as a type of parasomnia. It is an abnormal and disruptive sleeping behaviour. Other examples of this sleep disorder are bed-wetting, teeth grinding (Bruxism) and talking while sleeping.

Parasomnias are imbalances in the brain that cause a transition between the waking and the sleeping stages. This is not difficult to comprehend when one takes into account the kind of complex organ that the human brain is, along with the complexity of the sleeping cycle.

What is Sleepwalking?
To be able to categorise someone's sleeping behavior as somnambulism, one needs to notice the following symptoms:

● The person leaves the bed while sleeping (usually in the first one-third of the sleep cycle)
● Others find it difficult to wake him up while he is sleepwalking
● The sufferer has no memory of what happened while he was sleepwalking
● After waking up he displays confusion
● The individual is not suffering from dementia or any other such ailment
● The person's social life is suffering

Sleepwalkers have been battling different theories on their problem, such as, acting out their dreams, being patients of epilepsy, suffering from hysteria, carrying other dissociative disorders or acting under the compulsion of their secret desires.

The truth is that these are just theories. Research is still underway to completely understand the science behind sleepwalking, however, there are some distinct possibilities associated with sleepwalking that carry merit.

The Link between Sleep Stage and Sleepwalking 

The human body, during the first third of the night, is in non-rapid eye movement (NREM) stage of sleep, which is also called thedeepest stage of sleep. At this stage, the brain is very quiet, there are no dreams and yet the body is active. You will often see people in NREM sleep tossing and turning on the bed, changing positions, etc. This is followed by the rapid eye movement (REM) stage, where the reverse happens - your body is still and inactive but your brain is full of activity. All your dreams generally occur during the REM stage.

Sleepwalking is associated with the NREM stage - which explains why a sleepwalker, who is physically active, finds it so difficult to snap out of his sleep, even when others urge him to wake up. And once awake, the sufferer is usually incoherent for a while and has no recall of what happened. This also strikes down the theory that sleepwalking is a result of acting out your dreams - for in the NREM stage there are no dreams.

Sleepwalking Triggers in Children

It is important to note that most sleepwalkers are children - who usually grow out of it. This association is explained through the following argument:

The brains of children develop speedily, as they imbibe scores of stimuli each day. Such development in brain takes place in the initial years. Human beings never experience that rapidity of brain changes ever again in life.

Some experts say, these quick alterations are responsible for creating temporary imbalances - where one part of the brain may outpace another in development - due to which sleepwalking can be triggered.

Another theory that seeks to explain sleepwalking in children says, the brains of kids are too immature to comprehend and handle the different stages of the complex human sleep cycle. Therefore, it gets temporarily muddled. Later, this leads to episodes of somnambulism.

Yet another theory says, NREM sleep is the time when the body repairs itself and releases hormones, including growth hormones. As the release of growth hormone is appreciably higher in children, it is possible that these hormonal surges are what eventually lead to episodes of sleepwalking in kids.

Sleepwalking Episodes in Adults

In grown-ups, sleepwalking has been linked to seizures, sleep disorders and neurodegenerative conditions like Parkinson's and Alzheimer's. As a result, sleepwalking episodes in adults need to be taken much more seriously as compared to those in kids.

Professional medical help becomes very important in cases of adult sleepwalking episodes.

Other triggers of somnambulism in grown-ups can be excessive fatigue, chronic stress, the effect of certain medications, alcohol intake and illnesses like fever.

Dangers of Somnambulism and Managing the Condition

Sleepwalking episodes can last from just about a few seconds to, as long as say, half an hour. Sleepwalkers usually have glazed eyes and faces devoid of all expressions. The tricky point is that while they may look awake, they are actually asleep and can be quite clumsy.

However, sleepwalkers are capable of performing various activities, ranging from getting up and walking around the bedroom to driving a car, playing a musical instrument, and in very rare cases, even getting into a violent act!

To have a body that can move and function along with a mind that is sleepy and dazed is quite an inflammable combination one would say. It can be very dangerous, even fatal.

Mentioned here are some tips on how to handle a sleepwalker during an episode as well as how to manage and fight off the condition in the long run:

● Do not startle the sleepwalker
● Do not try to forcefully wake him up
● Gently guide the suffer back to the bedroom. It is highly unlikely that the person will have a repeat episode in the course of the same night
● Try and talk to him about his condition to make him aware. On his own, he may not realize that he is a somnambulist
● In case of a child, you should get him to start sleeping in your room. You can bolt the door from inside while going to bed. Take care to get the bolt positioned where the child can't reach it
● For adults, it is advisable to encourage them to consult specialist at the earliest. This will not only help manage their sleepwalking but can also result in the discovery of other related medical conditions
● Reducing stress levels through a good lifestyle is also recommended 

Read more here

Obesity and body fat in children are affected by chronic insufficient sleep

A study shows that chronic insufficient sleep can affect obesity and body fat in children.

One of the most comprehensive studies of the potential link between reduced sleep and childhood obesity finds compelling evidence that children who consistently received less than the recommended hours of sleep during infancy and early childhood had increases in both obesity and in adiposity or overall body fat at age 7. The study from MassGeneral Hospital for Children (MGHfC) investigators, published in the June issue of Pediatrics, also finds no evidence of a specific period during which insufficient sleep has greater influence on later obesity.

"Our study found convincing evidence that getting less than recommended amounts of sleep across early childhood is an independent and strong risk factor for obesity and adiposity," says Elsie Taveras, MD, MPH, chief of General Pediatrics at MGHfC and lead author of the Pediatrics paper. "Contrary to some published studies, we did not find a particular 'critical period' for the influence of sleep duration on weight gain. Instead, insufficient sleep at any time in early childhood had adverse effects."

While several studies have found evidence of an association between sleep and obesity in young children, few have examined the effects of constant sleep deprivation across time or used measures other than body mass index (BMI), which determines obesity based solely on height and weight. The current study analyzed data from Project Viva, a long-term investigation of the health impacts of several factors during pregnancy and after birth. Information used in this study was gathered from mothers at in-person interviews when their children were around 6 months, 3 years and 7 years old, and from questionnaires completed when the children were ages 1, 2, 4, 5 and 6.

Among other questions, the mothers were asked how much time their children slept, both at night and during daytime naps, during an average day. Measurements taken at the seven-year visit included not only height and weight but also total body fat, abdominal fat, lean body mass, and waist and hip circumferences -- measurements that may more accurately reflect cardio-metabolic health risks than BMI alone. Curtailed sleep was defined as less than 12 hours per day from ages 6 months to 2 years, less than 10 hours per day for ages 3 and 4, and less than 9 hours per day from age 5 to 7. Based on the mothers' reports at each age, individual children were assigned a sleep score covering the entire study period -- from 0, which represented the highest level of sleep curtailment, to 13, indicating no reports of insufficient sleep.

Overall, children with the lowest sleep scores had the highest levels of all body measurements reflecting obesity and adiposity, including abdominal fat which is considered to be particularly hazardous. The association was consistent at all ages, indicting there was no critical period for the interaction between sleep and weight. Lower sleep scores were more common in homes with lower incomes, less maternal education and among racial and ethnic minorities; but the association between sleep and obesity/adiposity was not changed by adjusting for those and other factors.

Facts and tips for healthy sleeping habits

While more research is needed to understand how sleep duration affects body composition, Taveras notes, potential mechanisms could include the influence of sleep on hormones that control hunger and satiety; the disruptions of circadian rhythms or possible common genetic pathways involved in both sleep and metabolism; poor ability to make good decisions on food choices and eating behaviors caused by sleep deprivation, or household routines that lead to both reduced sleep and increased food consumption. Insufficient sleep may also lead to increased opportunities to eat, especially if time is spent in sedentary activities, such as TV viewing, when snacking and exposure to ads for unhealthy foods are common.

"While we need more trials to determine if improving sleep leads to reduced obesity," she says, "right now we can recommend that clinicians teach young patients and their parents ways to get a better night's sleep -- including setting a consistent bedtime, limiting caffeinated beverages late in the day and cutting out high-tech distractions in the bedroom. All of these help promote good sleep habits, which also may boost alertness for school or work, improve mood and enhance the overall quality of life." Taveras is an associate professor of Pediatrics and Population Medicine at Harvard Medical School (HMS).

Read more here

Predictors of Persistent Sleep Apnea After Surgery in Children Younger Than 3 Years

I see patients all the time whose families are surprised to find out that surgery does not always cure sleep apnea. From this research, I am inclined to offer post-operative testing in children with risk factors. Parents should stay on alert for a recurrence of symptoms especially if they have risk factors for recurrence (young age, neurologic or developmental disorder, low tone, craniofacial anatomic problems, prematurity, lung disease to name a few...) JR

Predictors of Persistent Sleep Apnea After Surgery in Children Younger Than 3 Years

Andrea Nath, MD1; Janaki Emani, MD1; Dana L. Suskind, MD1,2; Fuad M. Baroody, MD1,2

[+] Author Affiliations

JAMA Otolaryngol Head Neck Surg. 2013;139(10):1002-1008. doi:10.1001/jamaoto.2013.4686.

Text Size: A A A

Article

Figures

Tables

References

Comments

ABSTRACT

ABSTRACT | METHODS | RESULTS | DISCUSSION | ARTICLE INFORMATION |REFERENCES

Importance  Obstructive sleep apnea (OSA) is a common disorder in children and can lead to important sequelae. Predictors of persistent OSA after adenotonsillectomy (T&A) in younger children are not well studied.

Objective  To evaluate residual OSA in a subgroup of children younger than 3 years after T&A and identify predictors of postoperative residual disease.

Design, Setting, and Participants  Retrospective review of medical records at a tertiary academic children’s hospital involving children younger than 3 years who had OSA documented by polysomnogram (PSG) and underwent T&A during the period October 1, 2002, through June 30, 2010. Some of these children had both preoperative and postoperative PSGs.

Main Outcomes and Measures  Effect of T&A on sleep study parameters and predictors of persistent disease after surgery.

Results  A total of 283 patients (mean [SD] age, 22 [7] months) underwent a preoperative PSG, with 70 of these patients having both a preoperative and postoperative PSG. In the group who had preoperative and postoperative PSGs, there were statistically significant improvements in mean (SD) apnea hypopnea index (AHI) (34.8 [40.7] to 5.7 [13.8]; P < .001), baseline oxygen saturation (96.6% [2.1%] to 97.2% [1.4%]; P = .05), minimum oxygen saturation (77.2% [11.4%] to 89.9% [6.8%]; P < .001), and sleep efficiency (84.7% [14.9%] to 88.7% [9.1%]; P = .02) after T&A. When AHI greater than 5 was used as the definition of OSA, 21% of the patients (15 of 70) had residual OSA. The most consistent predictor of residual OSA after T&A was the severity of preoperative OSA (P = .02).

Conclusions and Relevance  In a subgroup of children younger than 3 years with OSA, we found a high rate of residual OSA after T&A. Predictors of residual disease include severity of preoperative OSA as determined by PSG result. Postoperative PSGs might be indicated in these patients.

Study claims early repetitive behaviors may indicate autism risk

A study claims that early repetitive behaviors may indicate that a child is at risk for autism.

There may be a simple way to help spot signs of autism early on in siblings of children with the disorder, new research suggests.

The study, which included 184 children at high risk of autism, found that those who developed the disorder typically started showing some "red flags" as early as 12 months of age.

Specifically, they had an unusually high rate of repetitive behaviors, such as flapping their hands or arms, rocking back and forth, or focusing obsessively on one toy.

Some amount of repetitive behavior is normal for babies, said lead researcher Jason Wolff, an assistant professor of psychiatry at the University of North Carolina at Chapel Hill.

"But in typically developing children, that usually peaks around the age of 6 months," said Wolff, who is scheduled to present his findings on Saturday at the International Meeting for Autism Research, in Atlanta.

"In children who go on to develop autism, repetitive behavior is still highly prevalent, or even increasing, at the age of 12 months," Wolff said.

Wolff said an advantage of looking at repetitive behaviors is that parents can report on them with a simple "pen-and-pencil measure." And it's possible that such a tool could be used to screen for autism in average-risk children, too, he added.

More research is needed before repetitive behavior can be used as part of an early screening tool, according to Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York, in New Hyde Park, N.Y.

"This is a promising observation, but it needs refinement before it can be turned into something clinically useful," said Adesman, who was not involved in the study.

Wolff agreed. For one, he said, his team wants to fine-tune the way repetitive behavior is measured. And any screening tool would have to not only reliably catch autism, but also have a low risk of "false positives."

"But this study is a good start," Wolff said.

The precise causes of autism are not clear, but genes are involved. When a child has autism, his or her siblings are at high risk themselves -- with a roughly 20 percent chance of developing the disorder, Wolff noted.

And there's a "great need" for ways to spot those children early, he said. In general, Wolff noted, the earlier that speech and behavioral therapies for autism can be started, the better children do in the long run.

But until now, researchers haven't looked at whether repetitive behavior can serve as an early red flag.

"At one time, people thought repetitive behavior didn't really show up until preschool," Wolff said. But recent research, including the current study, has shown that to be untrue.

For the study, Wolff's team followed 59 children at average risk of autism and 184 who were at high risk because an older sibling had the disorder. When the children were 12 and 24 months old, their parents completed a standard questionnaire on repetitive behaviors.

Overall, 42 of the high-risk children were diagnosed with autism at age 2. And those children had shown many more repetitive behaviors at the age of 12 months -- an average of four to eight different types, Wolff said, versus one or two for kids without an autism diagnosis.

Still, that's an average difference between two groups, Adesman pointed out. The trick, he said, is to turn that into an assessment that can reliably spot the individual kids who will develop autism.

"There's a risk you could identify too many kids, and give some of them services that they don't need," Adesman said.

He agreed, though, on the need for early screening tools, and said this study points to one potential way.

Researchers are looking into other ways, too. In a separate study reported at the meeting, a team at Boston Children's Hospital used electroencephalograms (EEGs) to gauge brain activity in 208 babies and toddlers. They found that the readings, taken with electrodes on the scalp, were able to distinguish high-risk youngsters from children at average risk of autism.

And in some cases, the EEG readings were able to separate children who went on to develop autism from those who didn't.

Because findings from both studies were presented at a meeting and not yet published in a peer-reviewed journal, the results should be considered preliminary.

Read more here

How sleep apnea affects hearing

This article discusses how hearing is affected by sleep apnea.

Sleep apnea may not only affect the quality of your sleep. New research suggests that the sleep disorder may be linked to hearing loss as well.

The study found that sleep apnea was associated with hearing impairment at both high and low frequencies. That finding held true even after the researchers adjusted the data for other possible causes of hearing loss.

These findings give further support to the idea that sleep apnea likely doesn't occur in isolation. Instead, it may be a sign of other underlying health conditions, the researchers said.

"Sleep apnea is more of a systemic and chronic disease than just something that happens when you're sleeping," said one of the study's authors, Dr. Neomi Shah, an associate director of the pulmonary sleep lab at Montefiore Medical Center in New York City.

"It probably affects multiple different organs, so I would probably urge we start thinking about sleep apnea as more like a chronic disease with vascular and inflammatory issues," Shah added.

Sleep apnea is a common disorder that affects about 18 million Americans, according to the National Sleep Foundation. Typically signaled by snoring with periodic gasping or "snorting" noises, sleep apnea interrupts sleep and can cause excessive daytime fatigue and other symptoms. The condition also has been associated with generalized inflammation, cardiovascular and endocrine problems.

What might the connection be between sleep apnea and hearing loss? It might be a combination of factors that cause inflammation and abnormal functioning in the blood vessels, according to Shah. "The ear is prone to this kind of injury," explained Shah.

The study tapped data from almost 14,000 U.S. participants in the Hispanic Community Health Study/Study of Latinos. About 53 percent were women and on average the subjects were 41 years old. All completed in-home sleep studies and audiometric (hearing) testing.

About 10 percent of the study volunteers had sleep apnea. Around 30 percent had some form of hearing impairment, according to the study.

The researchers took into account age, gender, Hispanic/Latino backgrounds and health-related issues such as high blood pressure, diabetes, fat levels in the blood, cigarette and alcohol use, history of hearing loss or snoring, and noise exposure.

People in the study were more likely to have hearing impairment if they were of Cuban and Puerto Rican backgrounds, had a higher body mass index (an indication of being overweight), were people who snored, or had been diagnosed as having sleep apnea.

The study authors found that sleep apnea was associated with a 31 percent increase in high frequency hearing impairment and a 90 percent increase in low frequency hearing impairment. Sleep apnea was also linked to a 38 percent increase in both high and low frequency hearing loss. Speech tends to fall in the low frequency range, according to Shah.

The research is slated to be presented May 20 at the American Thoracic Society annual meeting in San Diego, Calif. Because the study has not yet been published in a peer-reviewed journal, the data and conclusions should be viewed as preliminary.

Some experts urged caution in interpreting the results of the study, however.

"The number one thing I always say is, correlation is not causation; it doesn't mean if you have sleep apnea you're at risk for hearing impairment," said Rebecca Spencer, a neuroscientist and associate professor in the department of psychological and brain sciences at the University of Massachusetts, Amherst. "You wouldn't know if one comes before the other: sleep apnea appears before hearing loss, or hearing loss appears before sleep apnea and maybe they don't come together at all. They may not be related except by a third factor."

Because a possible link has been discovered between sleep apnea and hearing loss, the next step should be a smaller study that looks more closely at the question of whether sleep apnea actually causes hearing loss, said Spencer.

She also pointed out that the data drew only from people of Hispanic and Latino descent. It would be important to look at the association between hearing loss and sleep apnea among a broader ethnic and geographical group, she added.

Only one thing can be concluded from the study, Spencer said: "There is the potential that treating sleep apnea may improve hearing loss."

Shah, the research author, said people with sleep apnea should be screened for hearing impairment since it has been shown to be associated with the disorder. "Get evaluated," she urged.

Read more here

Children's concussion symptoms stay after injury

A study shows that the symptoms of concussions in children stay long after the injury occurrence.

Kids who suffer a concussion can have lingering effects long after the physical symptoms fade away, U.S. researchers report.

In a study from the emergency medicine division at Boston Children's Hospital, doctors found that, while headache, dizziness and blurry vision can appear right after a concussion, emotional and mental symptoms, such as irritability and frustration, show up much later and stay longer.

"Patients and their families should expect the physical symptoms that they experience after a head injury to get better over the next few weeks, but that emotional symptoms may come on later, even as the physical symptoms subside," said lead researcher Dr. Matthew Eisenberg.

"Only by knowing what symptoms can be expected after a concussion can we help reassure patients and families that what they experience is normal, know when to seek additional help, and make sure that children are taking appropriate precautions in regard to school and sports to achieve a full recovery," Eisenberg added.

For the study, published online May 12 and in the June print issue of Pediatrics, Eisenberg's team used questionnaires to keep track of 235 children and young adults, aged 11 to 22, who suffered a concussion and went to a pediatric emergency department.

The patients were followed for three months after their injury, or until all their symptoms were gone. During that time they were asked about symptoms, sports activity, and school and athletic performance.

The most common physical symptoms were headache, dizziness and fatigue, which tended to start right after the injury and got better over time. Most also had mental symptoms, such as difficulty concentrating and taking longer to think, the researchers found.

While most children recovered within two weeks after the injury, 25 percent still had headache a month after their injury, the investigators found.

In addition, more than 20 percent suffered from fatigue, and nearly 20 percent reported taking longer to think for a month after their concussion.

For many, emotional symptoms -- such as frustration and irritability -- were not as common right after the injury, but developed later, the study authors noted.

Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Miami Children's Hospital, said, "It takes longer than people think to fully recover from a concussion. My experience is that kids who still have symptoms two weeks after a concussion are going to have a very hard time, and it's going to be a struggle to get them to the point where they have no symptoms."

In addition to physical and mental rest, Kuluz believes in treating the symptoms. He prescribes ibuprofen and other medications to relieve headache, and melatonin and other drugs to help patients sleep.

Kuluz also recommends physical therapy to help children recover. Therapy includes working on balance and helping with any vision problems. "Therapy also helps you find your threshold for exertion. Many of my kids find that very helpful," he said.

He also recommends keeping children out of school for a couple of days after the injury and then gradually letting them get back to a normal routine.

"Keeping a child out of school for too long will have a negative effect on their mental health. They will become anxious, they'll become irritable, because they worry about falling behind," he said. "But if they go back too soon without teachers being aware of their condition, they can fail, and it happens a lot."

Kuluz tries to get kids back to school for half a day or as much as they can tolerate until they get better. Children should not start sports again until all symptoms have disappeared and then only gradually, he added.

If a child still has symptoms two or three days after a concussion, Kuluz recommends seeing a doctor who is experienced in dealing with concussions or going to a concussion clinic.

Read more here

Research shows that children with autism have different bacteria in their guts

A study looked into the bacteria that children with autism have in their gut and concluded it is in different concentrations than the bacteria found in children without autism.

Children with autism spectrum disorders (ASD) have significantly different concentrations of certain bacterial-produced chemicals, called metabolites, in their feces compared to children without ASD. This research, presented at the annual meeting of the American Society for Microbiology, provides further evidence that bacteria in the gut may be linked to autism.

"Most gut bacteria are beneficial, aiding food digestion, producing vitamins, and protecting against harmful bacteria. If left unchecked, however, harmful bacteria can excrete dangerous metabolites or disturb a balance in metabolites that can affect the gut and the rest of the body, including the brain," says Dae-Wook Kang of the Biodesign Institute of Arizona State University, an author on the study.

Increasing evidence suggests that children with ASD have altered gut bacteria. In order to identify possible microbial metabolites associated with ASD Kang and his colleagues looked for and compared the compounds in fecal samples from children with and without ASD. They found that children with ASD had significantly different concentrations of seven of the 50 compounds they identified.

"Most of the seven metabolites could play a role in the brain, working as neurotransmitters or controlling neurotransmitter biosynthesis," says Kang. "We suspect that gut microbes may alter levels of neurotransmitter-related metabolites affecting gut-to-brain communication and/or altering brain function."

Children with ASD had significantly lower levels of the metabolites homovanillate and N,N-dimethylglycine. Homovanillate is the breakdown product of dopamine (a major neurotransmitter), indicating an imbalance in dopamine catabolism (the breaking down in living organisms of more complex substances into simpler ones with the release of energy). N,N-dimethylglycine is a building block for proteins and neurotransmitters, and has been used to reduce symptoms of ASD and epileptic seizures.

The glutamine/glutamate ratio was significantly higher in children with ASD. Glutamine and glutamate are further metabolized to gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. An imbalance between glutamate and GABA transmission has been associated with ASD-like behaviors such as hyper-excitation.

Using next-generation sequencing technology, the researchers also were able to detect hundreds of unique bacterial species and confirmed that children with ASD harbored distinct and less diverse gut bacterial composition.

"Correlations between gut bacteria and neurotransmitter-related metabolites are stepping stones for a better understanding of the crosstalk between gut bacteria and autism, which may provide potential targets for diagnosis or treatment of neurological symptoms in children with ASD," says Kang.

Read more here

Study: Concussion rates double in high schoolers

A study claims that rates of concussions have doubled between 2005 and 2012 for high school athletes.

The rate of concussions in U.S. high school athletes more than doubled between 2005 and 2012, new research shows.

The trend probably reflects an increased awareness and more legislation governing concussions in student athletes, and not more danger in sports, the study authors noted.

"The bottom line is that rates have gone up," said lead researcher Dr. Joseph Rosenthal, an assistant professor of physical medicine and rehabilitation at Ohio State University. "We don't know the exact reason. This was an observational study, so I can't say for sure, but I believe what is explaining the increase is the increased awareness, not that sports are more dangerous. It's just that the concussions are being recognized more, which is good news."

The study was published recently in The American Journal of Sports Medicine.

Concussions are usually due to a blow to the head, often in sports such as football or ice hockey, but they also occur in other sports.

The researchers analyzed data from a sample of 100 U.S. high schools that have one or more certified athletic trainers on staff.

Rosenthal's team found that the concussion rate increased from 0.23 to 0.51 concussions for every 1,000 athlete exposures. An athletic exposure is defined as a single athlete participating in one competition or a practice.

From 2005 through 2012, just over 4,000 concussions occurred in seven sports. These included football, soccer, volleyball, basketball, wrestling, baseball and softball.

Five of those sports had increases that were statistically significant. These included football, boys' basketball, boys' wrestling, boys' baseball and girls' softball. High school football had the highest rates of concussion, according to the study.

Increased awareness is probably behind the higher numbers, agreed Steven Broglio, an athletic trainer and director of the Neurosport Research Lab, at the University of Michigan in Ann Arbor. He is also chair of the National Athletic Trainers' Association position statement on the management of sport-related concussion.

"I'm not entirely surprised at this uptick," said Broglio. More concussions are being recognized due to a number of factors, including increased media coverage on the dangers of concussions and position statements about concussion management from organizations such as his, he added.

Another recent study suggested that awareness about the dangers of concussions is higher. Researchers from Children's Hospital Colorado tracked the compliance of high school athletes who suffered from concussions and how well they followed the return-to-play guidelines.

The researchers found that half of the athletes they tracked were compliant in 2007, but by 2013, 80 percent were. Those findings were presented at the recent annual meeting of the American Society for Sports Medicine in New Orleans.

All 50 states and the District of Columbia have some kind of law designed to protect young athletes from returning to play too soon after a concussion. Experts agree that children who have a concussion need evaluation by a health care professional and need to be cleared before they can return to sports.

Read more here