Syndromic autism

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Syndromic autism (or syndromic autism spectrum disorders) denotes cases of autism spectrum disorder that are associated with a broader medical condition, generally a syndrome. Cases without such association, which account for the majority of total autism cases, are known as non-syndromic autism (or non-syndromic autism spectrum disorders).

Contents

Studying the differences and similarities (e.g. common pathways) between syndromic and non-syndromic cases can provide insights about the pathophysiology of autism and pave the way to new autism therapies. [1] [2] [3] [4]

Syndromic autism

Autism spectrum disorder (ASD) is referred to as syndromic when it is one of the many characteristics associated with a broader medical condition, generally a syndrome.

Syndromic autism represents about 25% of the total ASD cases. [4] [5] In most[ quantify ] cases, its etiology is known. [2] [4]

Monogenic disorders are one of the causes of syndromic autism, which in this case are also known as monogenic autism spectrum disorders. They account for about 5% of the total ASD cases.

Certain[ which? ] syndromic forms of ASD can also have different[ compared to? ] phenomenology.[ clarification needed ]

Non-syndromic autism

Non-syndromic autism, also called classic autism or idiopathic autism (as in most cases, the etiology is unknown), represents the majority of total autism cases.

In most[ quantify ] cases, its cause is polygenic.[ citation needed ]

Classification

A 2017 study[ relevant? ] proposed to replace the classification "syndromic"/"non-syndromic" ASD into one based on the genetic etiology of the condition, specifying if the syndromic condition occurs in the context of a " phenotype first " clinically defined syndrome or from a " genotype first " molecularly defined syndrome. [4] [ clarification needed ]

Following the proposal, ASD would be divided into three genetic categories: [4]

Clinically defined

Syndromes recognized by clinicians (depending on their experience), typically confirmed by a targeted genetic testing.

Molecularly defined

Syndromes recognized by genome-wide testing, not by hypothesis-driven testing (since clinical recognition is difficult).

Currently undefined

Currently undefined.[ clarification needed ]

Characteristics of syndromic ASD conditions
ConditionCause Chromosome(s) involved (if a mutation)ASD prevalence (95% CI)Clinically/Molecularly definedOther characteristicsRef.
Fragile X syndrome Monogenic disorder :
FMR1 (encodes FMRP)
X  30% (20.0–31.0) [male individuals only]
 22% (15.0–30.0) [mixed sex]
14% (13–18) [female individuals only]
Clinically defined [in some males]Long/narrow face, macroorchidism, long ears and philtrum, hyperactivity, mild to moderate intellectual disability (ID), seizures [1] [3] [4] [6]
Rett syndrome Monogenic disorder :
MECP2
X 61.0% (46.0–74.0) [female individuals only]Clinically defined Microcephaly, breathing irregularities, language deficits, repetitive/stereotyped hand movements, epilepsy, ID [1] [3] [4]
MECP2 duplication syndrome Monogenic disorder :
MECP2
X 100% [in a single study composed by 9 male participants]Clinically defined Brachycephaly, spasticity, recurrent respiratory infections, gastrointestinal hypermotility, genitourinary abnormalities, epilepsy, ID [1] [4] [7]
Tuberous sclerosis complex Monogenic disorder :
TSC1
TSC2
9
16
 36.0% (33.0–40.0)Clinically defined Benign tumours in multiple organs, epilepsy [1] [3] [4]
Angelman's syndrome Monogenic disorder :
UBE3A
15  34.0% (24.0–37.0)Cheerful demeanour, microcephaly, epilepsy, speech deficits, sleep disturbance, epilepsy, ID [1] [3]
Phelan-McDermid syndrome Monogenic disorder :
SHANK3
22  84% [in a single study composed by 32 participants]Molecularly defined [4] [8]
Timothy syndrome Monogenic disorder :
CACNA1C
12  80% [in a single study composed by 17 participants]Clinically defined [4] [9]
Smith-Lemli-Opitz syndrome Monogenic disorder :
DHCR7
11 55% [in a single study composed by 33 participants] [10]
Neurofibromatosis type I Monogenic disorder :
NF1
17  18% (9.0–29.0)Clinically defined [3] [4]
PTEN hamartoma tumor syndrome Monogenic disorder :
PTEN
10  17% (8–27)Clinically defined [4] [11]
Down syndrome Chromosomal disorder :
trisomy 21
21 16% (8.0–24.0)Clinically defined [3] [4]
Cohen's syndrome Monogenic disorder :
VPS13B
8  54% (44.0–64.0)Clinically defined [3] [4]
Cornelia de Lange syndrome Polygenic disorder  43% (32.0–53.0)Clinically defined [3] [4]
CHARGE syndrome Monogenic disorder :
CHD7
8  28% (16–41)Clinically defined [4] [12] [13]
Noonan's syndrome Polygenic disorder  15% (7.0–26.0) [3]
William's syndrome Microdeletion syndrome :
7q11.23
7  12% (6.0–20.0) [3] [14]
22q11.2 deletion syndrome Microdeletion syndrome :
22q11.2
22 11% (5.0–19.0)Clinically defined [3] [4]
Fetal valproate spectrum disorder Teratogen :
valproate
 8–15% [in VPA exposed children]Clinically defined [4] [15] [16]

See also

Related Research Articles

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Asperger syndrome (AS), also known as Asperger's syndrome or Asperger's, is a term formerly used to describe a neurodevelopmental condition characterized by significant difficulties in social interaction and nonverbal communication, along with restricted, repetitive patterns of behavior and interests. Asperger syndrome has been merged with other conditions into autism spectrum disorder (ASD) and is no longer considered a diagnosis. It was considered milder than other diagnoses which were merged into ASD due to relatively unimpaired spoken language and intelligence.

<span class="mw-page-title-main">Fragile X syndrome</span> X-linked dominant genetic disorder

Fragile X syndrome (FXS) is a genetic neurodevelopmental disorder characterized by mild-to-moderate intellectual disability. The average IQ in males with FXS is under 55, while about two thirds of affected females are intellectually disabled. Physical features may include a long and narrow face, large ears, flexible fingers, and large testicles. About a third of those affected have features of autism such as problems with social interactions and delayed speech. Hyperactivity is common, and seizures occur in about 10%. Males are usually more affected than females.

<span class="mw-page-title-main">Conditions comorbid to autism</span> Medical conditions more common in autistic people

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Neurodevelopmental disorders are a group of mental conditions affecting the development of the nervous system, which includes the brain and spinal cord. According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) published in 2013, these conditions generally appear in early childhood, usually before children start school, and can persist into adulthood. The key characteristic of all these disorders is that they negatively impact a person's functioning in one or more domains of life depending on the disorder and deficits it has caused. All of these disorders and their levels of impairment exist on a spectrum, and affected individuals can experience varying degrees of symptoms and deficits, despite having the same diagnosis.

<span class="mw-page-title-main">Heritability of autism</span> The rate at which autism is inherited

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<span class="mw-page-title-main">22q13 deletion syndrome</span> Rare genetic syndrome

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16p11.2 deletion syndrome is a rare genetic condition caused by microdeletion on the short arm of chromosome 16. Most affected individuals experience global developmental delay and intellectual disability, as well as childhood-onset obesity. 16p11.2 deletion is estimated to account for approximately 1% of autism spectrum disorder cases.

<span class="mw-page-title-main">Fetal valproate spectrum disorder</span> Medical condition

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