The brain’s oxytocin system has been implicated in the neurobiology of autism (ASD), given the role of oxytocin in modulating social function in humans and animals more broadly. Previous work from members of our group reported dysregulation in oxytocin receptor (OXTR) binding in postmortem tissue from the basal forebrain in donors with autism compared to unaffected control donors. This study follows up on those findings by investigating the potential genetic and gene expression changes that could be driving those differences. We used adjacent sections from the same specimens from our previous study and performed duplex fluorescence in situ hybridization to visualize and quantify OXTR mRNA in the ventral pallidum (VP) and in the cholinergic magnocellular neurons of the nucleus basalis of Meynert (NBM), visualized with choline acetyltransferase (ChAT). We genotyped the brain samples using a SNP microarray on extracted DNA. We then used regression models to test associations between OXTR binding density, OXTR mRNA levels, and relevant OXTR SNPs. Additionally, we tested for correlations between age and OXTR mRNA. ASD specimens showed significantly greater OXTR mRNA than unaffected donors in both the VP and the NBM. Furthermore, this is the first demonstration of OXTR expression in the cholinergic neurons of the human basal forebrain; 73% of OXTR signal in the images of the ChAT+ neurons were colocalized with the cholinergic neurons. OXTR binding levels from our previous study were positively associated with OXTR mRNA in the NBM but only in the ChAT+ neurons there. OXTR binding levels were not associated with OXTR mRNA in the VP. We genotyped all specimens for three common SNPs in the OXTR gene that have been associated with ASD in the literature, but none significantly predicted levels of OXTR binding or gene expression in the NBM or VP. OXTR mRNA levels were strongly positively correlated with donor age across regions, which was driven by ASD specimens. Taken together, our results contribute to a more nuanced picture triangulating variation in OXTR gene sequence, gene expression, protein levels, and human behavior. Clinical trial number: not applicable.

Outcome measures currently used to assess function in Angelman Syndrome (AS) may be affected by participant anxiety in the clinic, use of a measure outside of age norms, and a reliance on caregiver report. This study aimed to leverage the process used to develop the Duchenne Video Assessment to develop, pilot, and evaluate tasks to be recorded in AS to lay the foundation for the Angelman Syndrome Video Assessment (ASVA), which is being developed for the assessment of everyday functional skills in individuals with AS in their home environment. The task list was informed by published conceptual disease models identifying four domains of interest (i.e. communication, motor skills (fine and gross), self-care and executive functioning) and determined by a team of experts based on family and clinician input. The study was conducted remotely in the home environment, with families capturing videos of everyday activities and participating in an exit interview about their experience. Videos were evaluated, and caregiver interview transcripts were coded and analyzed to determine whether each task would be included in the finalized measure. Eleven dyads (i.e., caregiver and individual with AS) completed the study. Individuals with AS between 4 and 39 years of age were enrolled. The video completion rate was 96%, with 99% of the submitted videos meeting quality standards. Caregivers endorsed the value of assessing these individuals in their home environment. The video capture list was reduced to 13 tasks for ambulatory individuals and 12 tasks for minimally ambulatory individuals. The ASVA is a novel tool that captures data on the daily functioning of individuals with AS in their home environment. If it is validated in the future, this tool presents a promising new approach to evaluate participant functioning in clinical trials and for clinical care.

BackgroundTo classify MRI patterns in children with cerebral palsy (CP) using the MRI Classification System (MRICS) and examine their associations with perinatal risk factors and clinical outcomes.MethodsThis retrospective cohort study included 1,403 children with CP who underwent post-neonatal cranial MRI between 2011 and 2020. MRI patterns were categorized using MRICS. We analyzed the associations between MRI findings and perinatal risk factors (e.g., gestational age, birth weight, sex, perinatal adversity, plurality) using univariate and multivariable multinomial logistic regression. Clinical outcomes—including CP subtype, gross motor function, intellectual disability, epilepsy, and composite impairment index—were assessed using chi-square, Kruskal–Wallis tests, and correspondence analysis.ResultsMRI abnormalities were observed in 86.5% of children, with predominant white matter injury (PWMI) being most common (46.5%). Preterm birth and perinatal adversity significantly increased the risk of PWMI and PGMI. PWMI was linked with spastic CP, better motor outcomes, and lower rates of intellectual disability. In contrast, PGMI and maldevelopments were associated with epilepsy, hearing loss, and severe impairment. Importantly, a subset of children with normal MRI findings still exhibited substantial functional impairments, emphasizing the limitations of structural imaging alone.ConclusionsMRI patterns, as classified by MRICS, provide critical insight into the neurodevelopmental heterogeneity of CP. Normal MRI findings do not preclude significant clinical impairment, underscoring the need for integrated neuroimaging and clinical-genetic assessment in CP management.

BackgroundImportance: The neurodevelopmental outcomes of children born after medically assisted reproduction remain incompletely characterized on a population level. We were to assess the incidence and relative risk of neurodevelopmental delay in the children of infertile women born after unassisted conception, intrauterine insemination (IUI), and in vitro fertilization (IVF).MethodWe conducted a retrospective cohort study using the National Health Insurance Service database of South Korea from October 2017 through December 2023. The study included 115 839 singleton, full-term, non–low–birthweight children born to women aged 20–49 years with a diagnosis of female infertility. The exposure was mode of conception—spontaneous, IUI, or IVF—balanced by propensity score matching on preconceptional maternal factors. Outcome measure was neurodevelopmental delay, defined as scoring below the cutoff in any of six functional domains on the Korean Developmental Screening Test across six consecutive rounds. Crude incidence rate ratios (IRRs) and adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models.ResultsAmong 115 839 children, 6 575 (5.7%) exhibited delay in at least one domain. Crude IRRs for any delay were 1.19 (95% confidence interval [CI]: 1.07, 1.61) for IUI and 1.10 (95% CI: 1.03, 1.17) for IVF versus unassisted conception. In the survival models, higher risks persisted for both IUI (aHR = 1.19; 95% CI: 1.06, 1.34) and IVF (1.09, 95% CI: 1.02, 1.06) compared with unassisted conception. When comparing IVF and IUI, IVF conferred a lower risk of fine motor delay than IUI (0.84, 95% CI: 0.72, 0.99). Among IVF births, risk of developmental delay was similar across all six domains for frozen and fresh embryo transfers.ConclusionsChildren conceived via IUI or IVF demonstrated a modest but significant increase in screen-positive neurodevelopmental delay compared with those conceived spontaneously. These findings highlight the need for neurodevelopmental monitoring in this population.Supplementary InformationThe online version contains supplementary material available at 10.1186/s11689-025-09658-w.

BackgroundHigh heritability (80–90%) of the autism spectrum disorder (ASD) and sex-biased incidence (3–4 times more boys than girls) suggest the roles of genetic predisposition and sex in the etiopathogenesis of the disorder. As ASD is commonly diagnosed in early childhood, most of the research is focused on children, yet animal research predominantly uses adult-aged animals. The effect of aging on the core and secondary ASD symptomatology is understudied, both in patients and animal models of ASD.MethodsTo investigate the effect of aging on sociability, repetitive behavior, exploration, locomotor activity, anxiety-like behavior, and object-avoidance behavior, behavioral phenotyping was conducted in Shank3B−/− (n = 67) and C57BL/6J wild-type (WT, n = 68) mice of both sexes (female n = 70, male n = 65) in adolescence (1–2 months of age, n = 42), adulthood (3–6 months of age, n = 40), and old age (12–18 months of age, n = 53).ResultsSocial deficits were observed only in old Shank3B−/− males. Anxiety-like behavior peaked in adulthood with Shank3B−/− mice roughly 20% more anxious than controls. Repetitive grooming and object-induced avoidance behavior were twice more prevalent in Shank3B−/− mice consistently across the lifespan. Hypoactivity (20% less distance moved) and reduced exploration (30% less rearing behavior) were recorded in Shank3B−/− mice and were more prevalent in female animals (30% less rearing behavior). Data were analyzed using the Three-way ANOVA (genotype, sex, age), followed by a posthoc Bonferroni correction to compare respective subgroups.ConclusionsPresent study shows that aging affects ASD-like phenotype in the Shank3B-mutant mouse model, even though the effect size seems to be small. The mechanisms underlying these partially sex-specific effects should be the subject of further research with potential translational implications.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and interaction, and repetitive behaviors. Males are three times more likely to be diagnosed with ASD than females, and sex-dependent alterations in behavior and communication have been reported both in clinical and animal research. Animal models are useful for understanding ASD-related manifestations and their associated neurobiological mechanisms. However, even though ASD is diagnosed during childhood, relatively few animal studies have focused on neonatal development. Here, we performed a detailed analysis of neonatal developmental milestones and maternal separation-induced ultrasonic vocalizations (USVs) in two genetic animal models of ASD, neurofibromatosis type 1 (Nf1±) and tuberous sclerosis complex 2 (Tsc2±). Nf1± and Tsc2± mice display strikingly distinct developmental profiles regarding motor, strength, and coordination skills. Nf1± mouse pups mostly show genotype-related differences, whereas Tsc2± mouse pups mainly present sexual dimorphisms. Furthermore, we found several differences regarding the number of USVs, frequency modulation, and temporal and spectral profile. Importantly, Nf1± animals tend to present sex- and genotype-dependent differences earlier than the Tsc2± mouse pups, suggesting distinct developmental curves between these two animal models. This study provides a nuanced understanding of how these two ASD models differ in their developmental trajectories. It underscores the importance of studying sex differences and early-life developmental markers, as these could offer crucial insights into ASD's progression and neurobiology. The distinct profiles of these models may help guide more targeted therapeutic strategies in the future.

BackgroundAutism spectrum disorder (ASD) is a group of neurodevelopmental disorders defined by stereotyped behavior and challenges in social communication and social interaction. ASD is associated with various comorbidities, including anxiety, gastrointestinal (GI) symptoms and sleep disorders. Evidence supports an association between intestinal dysbiosis and the severity of ASD-related symptoms. Probiotic intake was suggested to restore microbial homeostasis and decrease neurobehavioral, GI and sleep symptoms in individuals diagnosed with autism.MethodsThis study aims to evaluate the acceptability and safety of a Bio-K + probiotics beverage in autistic children aged 4 to 11 years and the feasibility of the proposed research protocol to measure its impact on behaviors and comorbidities. The 30-week study consisted of daily supplementation with Bio-K + probiotics for 14 weeks. Acceptability and safety were monitored throughout the study. Feasibility was assessed by comparing recruitment and completion rates to pre-established thresholds. Preliminary impact of supplementation on behaviors (Autism Treatment Evaluation Checklist (ATEC) score), GI symptoms and sleep disorders was evaluated.ResultsOf the 23 children recruited (mean age 6.7 ± 2.2 years, 70% males), 65% had GI problems and 91% had sleep disorders. Probiotic supplementation was accepted by all participants and no product-related adverse event was reported. Feasibility rates exceeded pre-established thresholds for almost all study outcomes including recruitment rate, compliance, electroencephalography, actigraphy and completion of questionnaires. Preliminary data suggest an improvement in behaviors associated with autism assessed with the total ATEC score, and in GI symptoms and sleep disorders.ConclusionThis study demonstrates probiotic beverage acceptability and safety and protocol feasibility in autistic children. To further support our data, a double-blinded placebo-controlled study is needed to determine its efficacy.

BackgroundSHANK2 disorder is a rare neurodevelopmental disorder caused by a deletion or pathogenic sequence variant of the SHANK2 gene and is associated with autism spectrum disorder (ASD), intellectual disability (ID), and developmental delay. To date, research in SHANK2 has focused on laboratory-based in vivo and in vitro studies with few prospective clinical studies in humans.MethodsA remote assessment battery was comprised of caregiver interviews with a psychiatrist, psychologists, and a genetic counselor, caregiver-reports, and review of records. Results from this cohort were reported using descriptive statistics. An age-matched sample of participants with SHANK3 haploinsufficiency (Phelan-McDermid syndrome, PMS) was used to compare adaptive behavior between the two groups.ResultsAll ten participants demonstrated delays in adaptive behavior, with most motor skills preserved and a weakness in communication. According to parent report, 90% of participants carried a formal diagnosis of ASD, 50% of participants carried a diagnosis of attention-deficit/hyperactivity disorder (ADHD), and mild-to-moderate developmental delays were noted. Sensory hyperreactivity and seeking behaviors were more pronounced than sensory hyporeactivity. Medical features included hypotonia, recurrent ear infections, and gastrointestinal abnormalities. No similar facial dysmorphic features were observed. Compared to PMS participants, individuals with SHANK2 disorder had significantly higher adaptive functioning.ConclusionsConsistent with previous studies of SHANK2 disorder, these results indicate mild to moderate developmental impairment. Overall, SHANK2 disorder is associated with developmental and adaptive functioning delays, high rates of autism, including sensory symptoms and repetitive behaviors, and ADHD. This study was limited by its remote nature, diverse age range, and the homogeneous racial and ethnic sample. Future studies should examine larger, diverse cohorts, add cognitive testing, capture longitudinal data, and include in-person assessments.

BackgroundChanges in brain connectivity during development are thought to reflect organizational and maturational processes that correspond to skill acquisition in domains like motor, language, and cognition. This theory is supported by findings in typically developing children as well as observations of abnormal connectivity among children with neurodevelopmental differences. However, few coherence studies have capitalized on the potential of sleep electroencephalogram (EEG) to examine the developing brain, especially among very young children for whom formal neurodevelopmental diagnosis is not yet possible. Sleep microarchitecture in young children may offer key insights into neurophysiological abnormalities associated with neurodevelopmental trajectories and potentially aid in early detection and intervention. In this study, we explored sleep EEG coherence and sleep spindles in typically developing toddlers and toddlers at increased risk of later neurodevelopmental diagnoses.MethodsWe investigated EEG coherence and sleep spindles in 16 toddlers with receptive and expressive language delay (LangD) and 39 typically developing (TD) toddlers. Participants were aged 12–22 months at baseline, and 34 (LangD, n=11; TD, n=23) participants were evaluated again at 36 months of age.ResultsAverage EEG coherence was stronger in the LangD group than the TD group, with differences most prominent during slow-wave sleep. Some age-related increases in coherence were observed, but these did not differ between groups. Sleep spindle density, duration, and frequency changed between baseline and follow-up for both groups, with the LangD group demonstrating a smaller magnitude of change than the TD group. The direction of change was frequency band-dependent for both groups.ConclusionsThese findings indicate that atypical sleep EEG connectivity and sleep spindle development can be detected in toddlers at risk of later neurodevelopmental diagnoses.Trial registrationhttps://clinicaltrials.gov/study/NCT01339767; Registration date: 4/20/2011.