Dynamic and Systemic Perspective in Autism Spectrum Disorders: A Change of Gaze in Research Opens to A New Landscape of Needs and Solutions

Abstract

The first step for a harmonious bio-psycho-social framework in approaching autism spectrum disorders (ASD) is overcoming the conflict between the biological and the psychosocial perspective. Biological research can provide clues for a correct approach to clinical practice, assuming that it would lead to the conceptualization of a pathogenetic paradigm able to account for epidemiologic and clinical findings. The upward trajectory in ASD prevalence and the systemic involvement of other organs besides the brain suggest that the epigenetic paradigm is the most plausible one. The embryo-fetal period is the crucial window of opportunity for keeping neurodevelopment on the right tracks, suggesting that women’s health in pregnancy should be a priority. Maladaptive molecular pathways beginning in utero, in particular, a vicious circle between the immune response, oxidative stress/mitochondrial dysfunction, and dysbiosis-impact neurodevelopment and brain functioning across the lifespan and are the basis for progressive multisystemic disorders that account for the substantial health loss and the increased mortality in ASD. Therefore, the biological complexity of ASD and its implications for health requires the enhancement of clinical skills on these topics, to achieve an effective multi-disciplinary healthcare model. Well-balanced training courses could be a promising starting point to make a change.

Intellectually able adults with autism spectrum disorder show typical resting-state EEG activity

“…Encompassing longitudinal data or data from multiple modalities might also increase effect sizes 40 , e.g., combining genetics (heritability was estimated to be around 83% for ASD 59 ), neuroimaging, psychological, and social information. The analysis framework we developed can be readily expanded to integrate with all of these modalities and support the development of a biopsychosocial model for ASD 60 , 61 .…”

An in‐depth analysis of the polyvagal theory in light of current findings in neuroscience and clinical research

“…Panisi and colleagues describe the pathogenetic model of autism in an epigenetic key and its clinical implications (Panisi et al., 2021). The model also considers the role of the VN as a bottom‐up path that informs the brain about the intestinal environment, influenced by nutrition, immune response, microbial balance, and environmental toxicants (Panisi & Marini, 2022).…”